It betrays a focus on profit for the industry, not the wellbeing of babies.

1. Counts for what?

In countries with clean water, the benefits of breastfeeding for term infants amount to 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infants in the first year. That’s the result of exclusive breastfeeding for months. There’s no evidence that this slight benefit even persists beyond the first year.

But the scientific evidence hasn’t stopped Baby Friendly UK from lying about the benefits. The claims that breastfeeding prevents obesity, diabetes and allergies have been debunked multiple times, but Baby Friendly UK insists on trotting out these discredited claims anyway.

2. It isn’t even true!

In order to demonstrate that every breastfeed counts, you would need to show a linear dose-response relationship between breastfeeding and the purported benefits on a granular level and that has never been shown. Moreover, there’s no reason to believe that it could be shown. Such assertions reflect an argument beloved of alternative health advocates that “if some is good, more must be better.”

Consider C-sections. Can you imagine the uproar if obstetrics adopted the motto “every C-section counts”? There’s no question that a minimum C-section rate (19% or higher) is necessary to achieve low perinatal and maternal mortality. But if we double the C-section rate we can’t expect that perinatal and maternal mortality will drop by half. Just because something is good (breastfeeding or C-sections), more of it is not necessarily better.

3. It reflects a belief that process is more important than outcome.

The truth, which ought to be obvious to anyone, is that every BABY counts. Every baby deserves whatever he or she needs to flourish and breast is NOT best for every baby.

The breastfeeding industry likes to claim that breastmilk is the perfect food. In order for breastmilk to be perfect, it would always be present in the perfect amounts, and all babies would be perfectly capable of extracting it from the breast. However, we know that 5-15% of women don’t make enough breastmilk to fully nourish a baby, and some babies have issues like low muscle tone that make it impossible for them to successfully breastfeed.

Go to any kindergarten class, of middle school class, or college class. Can you pick out the children who were breastfed from those that were bottle fed? And if the breastfed children were identified to you, could you tell who was breastfed longer? Of course not because breastfeeding simply isn’t that beneficial.

Look at child health parameters. Over the last 100 years, there have been wide-spread swings in breastfeeding rates from over 95% to a low of 24% (1973) back up to over 75% today. Despite these wide swings there has been no effect on infant mortality, life expectancy or IQ.

4. It betrays a focus on profit for the industry, not the wellbeing of babies.

The industry profits when it sells goods and services that aid breastfeeding. It does not profit from babies who are bottlefed so it has adopted a relentless focus on marketing breastfeeding itself, not on outcomes.

It’s no different from the oil industry that tries to convince everyone to heat their home with oil and not switch to natural gas, which is often cheaper and cleaner. The oil industry does not care what is better for you, your home and your environment. If it were it would acknowledge that natural gas is a better choice for some people, but to do that would undermine profits and profits come first.

5. It utterly ignores women’s fundamental right to control their own bodies.

The claim that every breastfeed counts isn’t merely untrue, but it is an ugly attempt at emotionally manipulating women into using their bodies in the industry approved way. Not every woman wants to breastfeed and the proven benefits of breastfeeding are so trivial that there is no reason to pressure or manipulate women into doing so.

The bottom line is that #everybreastfeedcounts is a marketing slogan not supported by the scientific evidence. The truth, though less profitable for the breastfeeding industry, is that every BABY counts and every MOTHER counts. If we truly care about babies and mothers we will stop crude efforts at emotional manipulation and promote an alternative motto:

To the lactivist asshole who thinks she should be aware of a woman’s personal and most intimate history in order to try and be what passes for a caring caregiver in her textbook: you aren’t entitled to anyone’s past. If you cannot be a decent professional, find another field. Preferably one where your potential to do harm will be lessened.

To everyone arguing respectfully with her: I am in awe of your patience. The asshole actively chooses to pretend that we’re discussing pre-term babies here and not healthy, full-term ones. She knows what she’s doing. That’s why she’s doing it.

guest

I don’t think I’m being fully “respectful” in my arguments. I cannot respect the opinions of someone who thinks we should lie to parents to manipulate their infant feeding choices, and who thinks rape survivors should have to tell every medical care provider they come in contact with their rape story in order to receive kind and compassionate treatment.

Amazed

Still more respectful than I am. And more than the asshole deserves.

Roadstergal

Another lactivist with zero respect for mothers. And who doesn’t read the papers she cites.

Roadstergal

What I have been doing more and more is substituting in ‘anal sex’ when the lactivists talk about ‘breastfeeding.’ Yes, it can be a wonderful thing. Yes, it comes easily to some women. Yes, it can promote bonding. And maybe you’ll never REALLY know if you can do it or will like it until you try it…

guest

I love this except I’m a little afraid that a movement is going to come along (probably out of the MRAs) advocating exactly that.

Roadstergal

I’m sure there’s a post to that effect on Return of Kings somewhere.

I’d think it would give lactivists pause to put ‘don’t you love this other person in your life enough to do this’ and ‘just push through the difficulty and pain’ and ‘you shouldn’t have gotten into this relationship if you weren’t over your hangups,’ etc into some sort of perspective… but I doubt it.

guest

I mean, it makes me want to run away screaming. But I’ve been single for nearly twenty years, so…

guest

And actually, Dan Savage sort of kind of does advocate this. He wouldn’t say you have to try it, but he puts a lot of pressure on people to be GGG (or he did, when I still read his column).

Nick Sanders

“GGG”?

LibrarianSarah

“good, giving and game”

Basically, a shorthand for “down for whatever.”

guest

And specifically, down for it even if you don’t personally like it – but you do it because your partner does like it. It works to an extent – I don’t care to give blow jobs because they’re boring to me. But it’s no big deal to give one to a partner who does like them – *for me.* The sense I got reading Savage was that he wasn’t fully empathetic to people, often women, who had hard limits on some things. Sometimes in a column he’d be supportive of a hard limit, but other times, not so much.

Nick Sanders

Thanks.

LibrarianSarah

Yeah the whole GGG thing always turned me off (pun, as always, intended). It feels very coercive and borderline rapey to me. “Oh there are certain sexual things that you refuse to do no matter how much your partner wants too? Well that’s not very GGG of you! You should at least try it once!”

Fuck that noise! I don’t let people play that game with food never mind sex. Though I am far from an expert on this subject as possible.

Roadstergal

I dunno, I can see taking it that way, but I always took it more as ‘be open to the idea,’ not necessarily doing it. And I think our experiences inform how we react. 🙂 For me, I’ve had kinks I’ve wanted to discuss with a partner be belittled, mocked, and denigrated, and it’s a fucking hammer-blow to my feelings of self-worth and self-love to have that happen. I don’t want someone to automatically try things just because I’m interested, but I think “GGG” should be about being open to the _idea_ of someone being turned on by something, even if it’s just plain Not For You.

BeatriceC

In the kink world this is called “YKISMK” Or Your Kink Is Not My Kink. The idea is that we all respect each other’s choices (so long as everything is between consenting adults), even if we personally don’t understand, don’t like, or are even disgusted by somebody else’s kink.

I do like American Dad – I think it’s a lot smarter, more sensitive, and a hella lot less misogynistic than Family Guy.

guest

They sound like they have better guidelines than Dan Savage. He always felt like he was trying to respect the really vanilla people, but couldn’t quite hide the fact that he didn’t, really. He’s just one person, though.

demodocus

i always found him educational, though i’m about as vanilla as possible.

Roadstergal

I’m pretty kinky and I generally like him. I don’t agree with everything he says, of course, but I think his attitude has evolved over time and continues to.

guest

Oh, sure. I’m not on a campaign against the man in general. I just thought about his GGG in this context.

LibrarianSarah

I think the problem is we are on opposite sides of the same spectrum. When your boundaries are “no penetration” belittlement, mockery and denigration is “just the tip” of the iceberg so I might be oversensitive.

Roadstergal

I can well believe, unfortunately. I think it’s what happens when you fall outside of the bounds of Norms. If you’re not the appropriate amount into penis-in-vagina – no more, no less! – it can feel like there’s someone walking behind you with a bell yelling “SHAME”…

LibrarianSarah

True but for me it’s more like “SO WHEN ARE YOU GOING TO FIND SOMEONE? WHEN ARE YOU GOING TO GET MARRIED? ARE YOU SURE YOU ARE NOT A LESBIAN? POSITIVE? THAT CAT IS NOT GOING TO LIVE FOREVER YOU KNOW? I’D STILL LOVE YOU IF YOU WERE GAY! I MEAN IT! SERIOUSLY! YOU SHOULD TOTALLY FIND A BOYFRIEND OR GIRLFRIEND WHILE YOU ARE STILL YOUNG AND PRETTY!”

And that is why I keep family visits to a minimum. tmi?

BeatriceC

BDSM terminology for those is “Hard Limits”. MrC knows he can push boundaries on my soft limits (things I don’t actually want to do, but I will for his sake), but if he steps one toe nail over my hard limits there will be Hell To Pay.

Charybdis

There is “discomfort” in the beginning as you are getting used to it. If you continue to have problems, then you need to see an “AC” (anal consultant), or “Asshole”.

The AC (Asshole) can check your positioning, suggest different positions, make adjustments to both you and your partner, check your sphincter, correct painful penetration and advise on lubricants.

Assholes can explain “power pumping” and recommend different sizes of dildoes/butt plugs so you get a comfortable fit. There is even a machine that can “power pump” for you, if you choose not to do so by hand.

Roadstergal

Do you know how much it hurts to snarf a latte out of your nose??

Charybdis

Sadly, no. I can’t stand coffee in any form. But I have snarfed Dr. Pepper out my nose before.

Sorry. 😛

sdsures

Ouch!

sdsures

As if the phrase switching wasn’t making me PMSL enough!

BeatriceC

I’m dying here. You may or may not know how close to the truth you really are. If you go onto kink sites there literally are threads from people asking how to make anal more enjoyable, or how to get started, “anal training” advise and what you wrote is basically what the responses are.

Roadstergal

Heck, you can buy Anal Trainer Sets now. *oldfart* Back in my day, we had to just take a deep breath… */oldfart*

Maybe the equivalent of pumping to increase supply?

BeatriceC

You know there’s inflatable butt plugs that you use an air pump with, right? So “pumping” really is the right word.

Roadstergal

There is? Oh, I need to look around more. (I’m a little more into wearing the fox tails.)

BeatriceC

MrC isn’t into the foxtail thing, but an ex was.

Roadstergal

I wish Mr R was. :[

BeatriceC

I know the feeling. There’s some really cute stuff out there. MrC just isn’t into clothing or accessories of any kind, even lingerie. He’s all for just plain naked.

Roadstergal

Yeah, I like naked fine, but I like to play with the outfits and roles during now and then, too.

Stephanie Rotherham

I think I love you.

BeatriceC

That is the best thing I’ve heard in months, at least. Maybe years.

Charybdis

Same here. Brilliant!

Amy Tuteur, MD

This morning I was on Today Show arguing against the closing of well baby nurseries:

Was able to watch it on inDemand-I appreciate you advocating for women being given options. You also have a very soothing voice

momofone

OT: I got a call from a friend this morning who sheepishly “admitted” that she started sleep training her almost-8-month-old last night. (I told her it was not a sin, and there was no need to “confess.” 🙂 ) She’s getting some flak, but believes the baby is not getting enough sleep, and she’s (the mother) definitely not. Does anyone have recommendations for resources that might be helpful? She’s winging it, and would like more information about how she might approach it. (She gave me info about their nighttime wakings, etc but I won’t post that unless it would be helpful.)

Healthy Sleep Habits, Healthy Child by Marc Weissbluth. Should have read it before my twins were born instead using it to troubleshoot problems at 9 months….

swbarnes2

I have that one (and next time you have twins, he has a book just for twins) but I wasn’t crazy about it. It just didn’t like how it was put together. Too many true stories about how miraculous a few nights of CIO was, a lot of talk about how important good sleep is. Yes, I already bought the pitch, I have the book. I don’t need the pitch, I just want instructions. At this age, what’s the approximate sleep schedule, what should I try if I observe this, what should I try if my baby is doing that…I felt like there were only about 2 useful pages in every chapter. Stuff like “Don’t worry about establishing bad sleep associations in the first few months”. That should have been highlighted and bolded, not just one paragraph among many.

Whew, I finally got my little guy sleeping through the night at about 10 months, and we’re now 2 months along of getting full night’s of sleep for all of us.

First we did the let him cry for ten minutes the first night then comfort him, then fifteen minutes the next night, then comfort. I spent a lot of time doing that. Weeks. It didn’t work. Like at all. It’s like he knew he just had to cry a little longer every night. Finally, I just said, I cannot physically do this any more. I wasn’t getting any help from my spouse in the nights, or the days for that matter, in fact, I’m still not, but whatever, I guess that’s a story for a different post (I work too, you know). Anywayyyyy, I was waking up five and six times a night. I wasn’t getting more than 3 hours of sleep at a time for ten months. So I finally broke down and just simply refused to do it anymore.

I decided to do my own version of cry it out, in this version, where, and I know this is crazy, I just let him cry it out. All night. After about two hours, he went to sleep and would periodically wake up throughout the night and cry for a long time and then go back to sleep. My friend said, “omg, that must’ve been so hard for you.” I looked at her like she was crazy and said, “um, I haven’t slept in ten months, so no. It wasn’t as hard as you might think.” For a while, I second guessed myself, that I traumatized my child for life.

Well, he was changed for life, but only for the better, and it only took two days. His whole demeanor changed once he could finally sleep. And I was a better mother for it too.

The AP crazies that have overtaken the Bump would not approve of this methodology, but whatever, it worked for us. And like I said, I was at the end of my rope with the sleep thing.

FWIW, he slept with us in our bed for the first six months attached to my boob, which is also supposedly really bad, or really good depending on whether you’re a doctor or an AP crazy. I’m neither, but it worked for us for a short time. (the bed part is bad, I guess, not the boob part). It was just convenient to just let lay there topless and let the little animal have his way with me while I slept through as much of it as was humanly possible.

sapphiremind

I do need to quibble about this slightly – breastmilk does make a difference, especially for preterm and critically ill infants. We have found that exposing them to any cow’s milk protein increases their incidence of necrotizing enterocolitis (NEC). For healthy, full-term infants, the benefits might be much more up for debate, but for the most fragile, I will never be in agreement that it is in any way equal.

corblimeybot

I can’t cite chapter and verse off the top of my head. But Dr. Amy has written many posts that seem to agree with your statement about preemies and NEC.

sapphiremind

It’s just that when people start getting it into their head that they are equivalent, it becomes that much more difficult to convince a mother to pump for her baby (which is a difficult job, no denying it). They aren’t the same, and absolutely formula is a billion times better than unsafe breastmilk or no breastmilk or not enough breastmilk, but it is a skill that is worth learning for both infant and mother, if possible.

Much like vaccine reactions, I think the vast majority of children do not see any sort of major harm from not receiving breastmilk. We can’t predict which children those will be and I am a great proponent of feeding the baby, no matter how it happens, as long as the child is term and healthy.

But I’ve seen terrible feeding habits with formula feeding and breastfeeding mothers alike. Diluting any food that the baby is receiving is not good and needs to be better taught that it is dangerous.

It’s also disingenuous to claim that the breastfeeding “industry” is the big profit makers in this situation – that’s really the formula makers.

denise

And who are the formula makers? The big ones are J&J and Abbott, right? Get rid off the entire Enfamil line. It won’t matter one bit to J&J. They have massive product lines. They are in pharmaceuticals and medical equipment. Now Medela on the other hand, relies solely on breastmilk. A lactation consultant relies on moms trying to breastfeed. Jack Newman doesn’t accept ON Medicare although he is a pediatrician. His office makes the big bucks out of people’s pockets.

sapphiremind

It’s still big money for J&J and Abbott both. And all the store brands. Yes, Medela makes money, so do lots of baby supply people. I don’t deal with Jack Newman. It’s not a breastmilk conspiracy. There’s not the money behind it.

denise

They make a lot of money, and that “lots of money” is literally a drop in the bucket. They don’t depend on formula. Assuming you are an LC, you depend on breastfeeding, or specifically women that have difficulty breastfeeding.

sapphiremind

I’m not an LC – I’m an NNP – which means I see the babies who are hurt by improper feeding or feeding difficulties in general. My only skin in the game is healthy babies.

Erin

Then you also have to consider the damage that breastfeeding or the drive to breastfeeding can do. Every psychological study I’ve read on the subject is clear that PnD and other mental health conditions in Mothers can have a long lasting and negative effect on their children’s development.

I’m 100 percent sure that breastfeeding didn’t help my PnD and PTSD but yet people (Midwives in particular) kept pushing it. In fact on seeing that it was making the situation worse, they kept pushing it. The cynic in me thinks that’s not because they gave a damn about my son but as a woman who had an emcs after a long labour but whose milk came in quickly and whose child could latch, I was a statistic and that’s all that mattered.

Having relived being raped during my emcs, then having to go to NICU and breastfeed without any privacy whatsoever, with fathers, grandfathers and male doctors wandering about. When asking for a screen which you know they have causes a huge drama…when their answer to you finding it triggering it, “shouldn’t have got pregnant without being over being raped”. When the decisions you’re making to try and keep yourself alive are framed as being selfish or bad for baby…then you see how stupid the whole system is. Must breastfeed at all costs because of x or y but it doesn’t matter the damage you do to them because you’re a suicidal mess.

You have to look at the big picture. I’d rather cut my own throat than pump and hand expressing in the first few days…it’s not a case of not being willing to do what’s best for my children but more a case of doing it is likely to make me incapable of being a parent. What’s more damaging, formula or growing up without a Mother because she killed herself when you were hours old?

In one of your posts further up this thread, you essentially make out that formula feeding is laziness…but you don’t know why someone isn’t breastfeeding unless they tell you.

At the moment I have zero intention of breastfeeding number 2. That might change but it might not, however I won’t be discussing any of the stuff I’ve mentioned here with any of the staff involved in our “care”.

sapphiremind

I said nothing of the sort that laziness was involved. But that the baby needs to be fed. I will say, if you don’t mention any of your past trauma to your caregivers, they are not able to give you optimal care. They will continue to seem pushy because they won’t know of how it affects you.

It’s very judgmental though to think that people cared nothing for your child and saw you only as a statistic. They likely saw you as a mother who was making milk well with a baby who was latching well, and that was great for him and why not allow him? You presented your reasons and I won’t debate those because it’s not my place. But their reasoning was likely out of happiness and excitement and not to make you as miserable as possible.

Charybdis

But Erin said that she had TOLD them that she found it triggering and they replied callously. It certainly doesn’t *sound* as if they were really listening to Erin and her reasons for not wanting to breastfeed. They were more interested in the fact that she had breastmilk and that her baby could latch and that SHE WAS NOT BREASTFEEDING.

Even *if* it was coming from a place of happiness on the staff’s part (as you alluded to in your reply), they were NOT respecting the mother’s decision to formula feed based on her mental and emotional state at the time. They went so far as to tell Erin that she shouldn’t have gotten pregnant if she was not “over being raped”. It was a rude, self-righteous and condescending reply to a new mother; certainly not warm, compassionate care one might expect in a nursing professional.

Erin

Perhaps it wasn’t your intention but “one requires no extra work or learning or effort from you, the other is going to be harder to learn, but confers no benefit” comes across as implying that to me.

As for optimal care, I was honest with those who were providing “care” with my son. I was told that it was my fault for getting pregnant if I wasn’t over being raped. I was told it was my fault my son got stuck and didn’t descend because I hadn’t dealt with my rape trauma. I was told that I just had to work through the “triggers” even though I was a broken sobbing mess. I was told I was being inconvenient when I asked for a screen even though NICU was full of men. I tried to hand express and I can’t describe to you how horrific it was to me, only that it left me wanting to slice my nipples off so I couldn’t do it any more. I was accused of lying about my section because I could move okay and ended up having to show a fairly crowded NICU my bandages before they’d believe me and get me a chair. I tried to kill myself when he was 30 odd hours old and they knew that, knew that breastfeeding was making the situation worse, but kept pushing me and pushing me. There is more but if I keep listing things I’m likely to end up far too angry and I’m trying to keep my stress levels down.

So no it’s not judgmental of me to say that they didn’t care because you don’t push someone over the edge if you give a damn. You don’t say the sort of things I had said to me when I was already in the midst of a mental breakdown. I didn’t have the baby blues, I wasn’t a bit hormonal…I was right back with the panic attacks, the flashbacks, the anxiety, the burning desire to kill myself to make it all go away so how anyone could possibly have thought I was a happy and excited new mum, I can not possibly imagine.

I stuck breastfeeding out for 3 months because I believed from the bottom of my heart that I’d failed my son when I couldn’t give birth to him. That maybe they were right and if I hadn’t run away from rape counselling because I can’t talk about my feelings very well, things would have been different. That I had to keep going because I didn’t feel anything for him at all and all everyone said was that breastfeeding would fix it. It didn’t and I know from women in my rape support group that I’m not alone.

Perhaps I’m being unfair to those who have to deal with me and baby 2 but honestly, I’m so angry about the way I was treated with baby 1 I couldn’t care less. I don’t want optimal care, I want minimal inference from people who act like they’ve got the empathy of a dead frog.

sapphiremind

I can’t argue with your experience at all – I wasn’t there. Maybe there was a group of people there who were intent on harming you as much as possible, and if that is true, you should be reporting them to their respective boards. Otherwise, it was misguided, but well-intentioned. You can assume everyone is like that, or you can try and make a better experience for yourself, and not just through hiding everything from everyone and being angry. But of course, that is your choice.

Dr Kitty

You’re a peach.
Rude, condescending, completely lacking in compassion and victim blaming, all in one post.
Nice.

Are you sapphiremind because you’re cold, hard and difficult to change?

denise

I am disgusted. My suspicions have been confirmed with this thread. She is a lactivist troll. I can’t believe we have wasted time debating with her.

Erin

Sorry but telling me that I shouldn’t have got pregnant if I wasn’t over being raped, that my son didn’t descend because of a mental block and that the Doctor who essentially saved my life was “a woman hating bastard” who gave me an “unnecessary episiotomy” during a failed forceps attempt (he didn’t for the record give me one at all but I only discovered that months later because I believed what I was told by a “care giver”) doesn’t meet my definition of “well intentioned”.

Well intentioned suggests that their ultimate aim was to help me and/or my baby. How does telling me that it was my fault I ended up with an emcs help me? My fault that I ended up reliving being raped on the operating table, ended up still having nightmares months later. How does telling me I shouldn’t have got pregnant if I can’t cope with expressing or breastfeeding because of being raped help me? I did get pregnant, I thought I was over being raped until it came rushing back. How does telling me that the Doctor is a woman hating bastard help me when I have a massive hole in my memory and I don’t know why I needed a section help me? I don’t believe that they all set out to cause harm, trust me when I say they wouldn’t still have a job if I believed that but I don’t buy “well intentioned” either.

Given the written apology I received from the hospital plus their attempts to give me whatever I want however much they hate what I’m asking for this time around I get the impression it’s not their idea of “well-intentioned” either.

As for a “better experience”, well that’s in the eye of the beholder isn’t it. Luckily I have a supportive Consultant OB who despite hating every single aspect of my birth plan is supporting me with it.

Stephanie Rotherham

Erin, you are an incredibly brave woman. I am so sorry that you went through something so awful twice and I hope you are in a better place now.

This is some of the most toxic crap I’ve read on the internet today. Erin, I’m sorry you’ve even had to read such callous dismissal of your experience.

Erin

To be honest, it doesn’t bother me on a personal level although it would have once upon a time.

What makes me seethe with a burning rage though is the fact that other women in situations like mine are potentially going to have to deal with the same rubbish.

Who?

Isn’t the bigger problem that it was overreach and ultimately harassment? They weren’t intent on harm, I’m sure, but they were intent on hammering their point home.

As someone pointed out, if you agree to something someone wants you to do, you are generally left alone to do it, not hounded about whether you’re sure, whether you’ve thought it all the way through etc.

Either the people Erin dealt with thought she should be able to make the decision she wanted, or they thought if they hassled her long enough she would make the decision they wanted her to, dressed up as her decision.

The former is advice, the latter is harassment.

Guest

The appropriate response here is “I’m so incredibly sorry that happened to you. That’s awful.” Or something like that.

You should be ashamed of yourself.

guest

Seriously. “Good intentions” are no excuse for being shitty.

Charybdis

Unless YOU were there, you cannot claim that their treatment of Erin was well-intentioned. It was bullying, by people who clearly value their NCB/Breastfeeding at all costs ideology above all else, even the mental, physical and emotional health of the mother, who also happens to be a patient who needs care and attention.

You can help make the experience less odious by understanding that it is not YOUR choice on how to feed a baby and support the mother and baby in that choice. You could work on not being condescending and believing what the mothers tell you regarding their choices for feeding their baby/babies, and not assuming they need more “education, support or encouragement” to make the choice YOU want them to make.

You do not sound well-intentioned, no matter how much you insist you are.

sapphiremind

I just, like I do with NCBers who bitch about the horrible medical people, acknowledge that everything comes through a filter. If there was misconduct, report it. Bullying is misconduct. It shouldn’t be allowed. But I have seen (not just here) how words, perception and intention get twisted in the eye of the beholder. There’s no malice on any side. No one is cackling and joyfully hoping to push a mother to suicide.

That’s what you are saying on the opposite side, that if the people were not well-intentioned, that their sole goal was to harm the mother in question. They had no purpose but to cause her pain and suffering in a sadistic fashion. Now, It could be that every single person on that L&D unit was like that. Or it could be that perhaps that was not their intention.

Guest

No, you’re missing the point. Their aim was to get her to breastfeed, among other things. They actually didn’t CARE if that harmed her psychologically, the only thing that mattered was whether or not she breastfed – the whole forest for the trees thing. And guess what, if you reduce a woman’s value down to her breasts and vagina, occasionally you’re going to hit on some very vulnerable people and cause incredible damage because you fail to see them as complete and whole people who have interests and concerns far more pressing and urgent then how their (term) baby is fed, between 2 perfectly adequate options.

Erin

I actually think it wasn’t a case of
“They actually didn’t CARE if that harmed her psychologically”
but that they didn’t believe it was possible for things like breastfeeding to cause psychological harm. I’d be posting this from an off shore tax haven if I had a £5 for everyone who told that me that breastfeeding prevents postnatal depression for example.

guest

I actually suspect that they didn’t believe they were harming her. They probably decided she was being a “drama queen” or something similar, which gave them the permission to treat her harshly. It’s bullshit, but that tends to be how human minds work.

Amazed

Was it not your intention to subtly put Erin down? Because that’s what it looks like to me.

Roadstergal

It wasn’t all that subtle. “I can’t argue with your experience at all – I wasn’t there.” Clearly, if Sparkly Sapphire had been there, she would have seen the reality of the situation and be able to mount a devastating argument to Erin’s obviously hysterical and confused recollection.

Barf.

Amazed

And convince her in the absolute superiority of breastfeeding for her – Erin’s – own baby.

sapphiremind

Nope, not my intention. Just trying to get others to see it from the other side of the fence. That medical professionals are people too and they are not trying to cause harm to any of their patients.

Megan

Many of us are “on the other side of the fence” and we still see your comments as completely lacking any empathy.

sapphiremind

you’re right. Because this is not a face-to-face issue and I do not know the poster, I was more interested in root-cause and prevention of additional problems. It’s a message board. I don’t connect with people the same way.

Roadstergal

The root cause is that a woman’s decision not to breastfeed isn’t respected.

Nick Sanders

By “don’t connect with people the same way”, do you mean you don’t see her as a person, just a situation that you need to tilt and turn until you can frame it in a way that proves you were right all along? Because that’s the way it looks to me, and I’ll tell you right now that I’m someone who doesn’t do normal interpersonal connections, yet you are making even me feel disgusted at your gross level of disconnection here.

Irène Delse

Sapphiremind: In case you’re not familiar with the First Rule of Holes, it’s “Stop digging”.

Amazed

Then you’re doing a great job even without meaning it. You mean you can get more patronizing, insulting, and lacking empathy if you TRY?

Charybdis

Regardless if it was their intention, that is the effect they produced. I don’t think they were actively cruel and sadistic, nor do I think they cackle gleefully over their cauldrons whilst chanting “Double, double, toil and trouble”.

I DO think they enamoured of their ideology and wish to spread the gospel of Breastfeeding to all the non-believers of the world. Especially to those who have heard the message but did not immediately convert to their side, or those who have heard the message but actively choose another path. In their evangelical zeal of EBF at all costs, they do not take all factors into consideration when someone opts to not breastfeed and will wind up alienating some mothers.

Some are actively evil, however most seem to fall into the “frenemy” category. These are the ones who ooze saccharine sweetness while trying to get the mother to toe their party line.

Megan

You know who this kind of rhetoric reminds me of? Donald Trump.
1. Say something offensive to a group/minority/whomever.
2. Deny that your intent was cruel and insist everyone is just “taking it the wrong way.”
3. Rinse and repeat.
Disgusting.

Charybdis

Their sole goal was to get Erin to breastfeed, period. That’s all. Her milk was in, son was latching well and she could come up to the NICU even though she had just had a CS, so OF COURSE she could/should breastfeed!

Breastfeeding was their intention, the mental and emotional anguish Erin experienced was just an unfortunate “misunderstanding”. I doubt her thoughts and feelings on the matter even registered with them.

Stephanie Rotherham

Since everybody here is being much more polite and respectful than I could ever be when arguing with you, I will just say there there are not enough words in the English language to describe what a despicable, cowardly, awful speck of a human being you are, and how utterly terrifying your lack of empathy and respect for others is, you self centered sociopath.

My rabbit is a better person than you are, and she eats her own poop. Sut down, shut up and learn, or go crawl back under the slimy rock you came from with the other disgusting insects.

sapphiremind

Yes, a self-centered sociopath asks you to see more than one perspective on an issue. How terrible of me.

Your personal insults clearly show you to be the better person. I’m sure you feel very superior to me in this moment.

Stephanie Rotherham

Oh honey, I really could not give a flying fuck what you think of me; I am neither decent nor good, but I sure as hell am better than you because when I hear a story of a rape survivor being forced to the brink of a mental breakdown and suicide ideation, I don’t start making excuses about her healthcare providers having ‘the best intentions’ when they were literally bullying her to death, and over, what? Breastfeeding? Just because you can feed your child one way doesn’t mean you should or that you have to. That fact that you cannot express even an ounce of sympathy for such a horrendous experience, instead completely downplaying the whole thing and writing it off, clearly speaks to how vestigial your empathy truly is. Frankly I don’t need to insult you as you’re doing a fine job showcasing your vile attitude to all. ‘More than one perspective’? The perspective that we should reduce women to a couple of bodily functions and sacrifice their lives and mental health at the alter of breast is best? Maybe you should just shut the fuck up and go away now; you obviously won’t listen to reason, and won’t get anyone here to listen to bullshit, so go spend your energy on applying for sensitivity training, you twit.

rosewater1

Aside from apologizing to Erin and walking away there is really very little for you to do here. THIS ISN’T ABOUT YOU.

You made your point. Not very well and not at all compassionately in my opinion, but you made it. Then when the criticism started you got defensive and tried to “explain” and “teach” us. That’s not working and it isn’t appreciated.

What are you still doing here if all that is coming your way are (to your mind) insults? Go play in friendlier backyards.

momofone

How helpful for you to clarify her options, since you are so well-acquainted with them and with her experience.

Amazed

I can’t argue with your perception of the situation at all – I am not there. Maybe you do have Erin’s best interests in mind and if that’s true, I should be asking you for apology since you are misguided but well-intentioned.

Or perhaps it’s just your choice to he the patronizing, pretending sympathy, passive-agressive bullying asshole you look like to me.

You are no different from the worst option for Erin’s healthcare providers. Fuck you, asshole. I am terrified that you are involved in the care of vulnerable women. Fuck you, monster.

Roadstergal

Upvoting not for the story, but for the fact that you were able to get through it. What a hideous experience. 🙁

An Actual Attorney

I’m sorry, telling Erin she shouldn’t have gotten pregnant of she wasn’t over her rape was from a place of happiness? That’s a weird conception of happiness.

sapphiremind

I wasn’t referring to that specifically. I was referring to in general, that I did not think all clinicians were in a conspiracy to harm her as much as possible.

An Actual Attorney

She didn’t say that. She was saying that they missed the forest for the one tree. And, really, how big of a dolt do you have to be too double down on c they were happy for her ” in the face of them telling her that she shouldn’t have gotten pregnant? Just admit they were focused on the wrong thing?

swbarnes2

“Their purpose wasn’t to hurt her, they merely observed they were hurting her, and didn’t give a shit about her welfare” is not the wonderful argument you seem to think it is.

Dr Kitty

It doesn’t matter.
If someone is miserable breastfeeding, you don’t need to know all the details.
Women have a right to privacy.
Continuing to be pushy isn’t trying to give optimal care, it is disrespecting patient autonomy.

“Why not allow him?”
“Because I’d rather not”.

You shouldn’t HAVE to justify yourself to strangers.

You know that patients don’t have to have good or logical reasons to refuse treatment, as long as they understand risks and benefits they can refuse for any or no reason, and you don’t have a right to know what that reason is.

“I am aware of the current breastfeeding advice and despite that I have chosen not to breastfeed. I do not wish to discuss it further”.
That is enough. It needs to be enough.

sapphiremind

“Why don’t you want to give vaccinations” “I’d rather not” “Why don’t you want to give vitamin k” “I’m aware of the risks and I’ve chosen not to give it, I do not wish to discuss it further”.

I have no idea whether they actually understand the risks or benefits of treatment if they shut down discussion.

Dr Kitty

Except adults are assumed to be competent to make medical decisions unless proven otherwise.

You can *offer* information, but they are within their rights not to agree to discuss it further.

Unless someone lacks the ability to retain, believe or balance information, you are supposed to respect their autonomy.

I have exactly two actively non vaxxing families in my practice.
One refuses to attend to discuss further.
One keeps agreeing to appointments for vaccines and then not showing up.
So yes, if someone says “nope, don’t wanna, you can’t make me and I don’t want to talk about it” they are perfectly within their rights, and frankly I prefer it to “absolutely, yes I will” to get us to back off, and who then doesn’t show up.

Think about it this way:
If someone wants to do something you agree with, do you spend as much time counselling them about the risks and possible negative consequences of their choice? Or do you assume that they have all the info they need to make that choice?

If someone said “I’m aware of the benefits of breastfeeding/vaccination/vitamin K and that’s what I want to do and I don’t want to discuss it further” are you happy that THEY understand their choice? Or do you insist on talking about it further to make sure that they really understand the issues.

corblimeybot

You’re basically dissembling at this point. The benefits of vaccinations and vitamin K exponentially outweigh the benefits of breastfeeding. Even comparing these things indicates you are extremely biased.

guest

And they don’t require the use of the mother’s body to accomplish.

Azuran

Vaccination and vit K are two very simple and fast medical procedures, it takes 5 minutes tops to, is painful to babies for about 5 seconds, and the mother’s only effort is holding the baby. It also has very well documented huge benefits.

Breastfeeding is a daily commitment that lasts for months, sometimes over a year. Without any break, a lot of effort, often a lot of pain. And with benefits that are, for most cases, not really noticeable.

It’s a stupid comparison.

Nick Sanders

Further, vaccine refusal affects people beyond just those who do not receive the shots.

sapphiremind

For me, it’s not. It’s going with medical establishment and EBP. Vaccinations, hospital birth, breastfeeding, those are all established by current evidence, standards and people far smarter than myself as the best and safest choices. WHO, AAP, ACOG, all agree on all of those topics.

Monkey Professor for a Head

It’s one thing to advise breastfeeding. To give genuine help to people who wish to breastfeed. It’s another thing to exaggerate the benefits, to pressurise women at a very vulnerable time, and to judge women who do not breastfeed.

Why is it always all or nothing when it comes to breastfeeding advocates (and I mean this in general, not referring to you specifically). Why is it not enough to say that breastfeeding has some benefits but it is not a magical panacea? Why is it a bad thing to acknowledge that there are downsides to breastfeeding too? What is wrong with acknowledging that there are multiple factors involved in whether breastfeeding or formula works best for any particular mother/baby pair?

Azuran

Except that breastfeeding requires the mother’s body.
If breastmilk came from bottles or tap, then yea, it would probably the the recommended source of nutrition and formula wouldn’t be a thing.
But it’s not, it comes from the mother’s body, so in the end, it’s her choice.
So, what are you suggesting? That we should force mother to breastfeed? shame them? tell them they are inadequate mother? That they are hurting their kids? That they shouldn’t be mothers?

I’m pretty sure all those health organization also recommends healthy eating habits and exercising every day. Do you go around watching what stranger eat and feed their kids? Do you ask them how much exercise they get? And then tell them they should be more careful because the WHO sais so? No? Then leave mothers alone.

Charybdis

Why do people hold up WHO as the gold standard for first-world, developed nations? Because it’s recommendations are for developing countries whose societies, structure, medical care and “safety nets” are minimal and/or subpar.

Daleth

It is a stupid comparison because you’re missing the point: one of these things (breastfeeding) imposes a major burden on the mother for many, many months, as well as potentially imposing a huge financial burden on her family since she can’t work. And on top of that, any benefit it may have for full-term infants is negligible.

The other imposes as close to zero burden on mom and the family as it’s possible to impose–it takes two minutes, boom, done. And the benefit to both the baby (immunity) and society (herd immunity) is pretty significant.

There is a big difference between urging someone to do something that takes two minutes, doesn’t infringe their bodily autonomy at all, and confers a major benefit, and urging them to do something that takes 12 months, infringes on their bodily autonomy that entire time, and confers at best a negligible benefit.

momofone

Whose happiness? Clearly not Erin’s.

guest

The reason “why not allow it?” is NONE OF YOUR BUSINESS. If the baby is being fed adequately and appropriately (that is, with *either* breast milk or formula, properly prepared) then you should never, EVER pressure a mother to change her method, or to continue something that is visibly making her unhappy. Why should Erin have to explain to everyone that enters her room that she’s a rape survivor? Who are you to burden her with retelling her story again and again just to make you leave her alone?

sapphiremind

She shouldn’t, but someone taking care of her should know and it should be in her chart along with proper instructions on how to care for her. Otherwise it’s setting the caregivers up to cause harm to the patient because they are unaware of the trauma. It’s like having a broken hand and then not telling someone when they shake it. Their intention is not to harm. If they knew they were causing pain, they likely would not.

Monkey Professor for a Head

I think the problem is that the benefits of breastmilk have been so exaggerated that those people felt that it was worth mistreating Erin if it resulted in her breastfeeding. They felt that the damage they did to her was less than the damage that he child would sustain from formula (obviously not true), and therefore that their behaviour was justified.

If you exaggerate the benefits of breastmilk and demonise formula, even if it’s with the best of intentions, there will be unwanted consequences.

sapphiremind

Again then, it is done with good intentions, even if they are misguided. I don’t agree that formula is evil. It could be they thought she wasn’t bonding with the baby and they mistakenly thought they were helping. There’s a million different reasons and excuses that could have occurred, that I can’t know. All I can say is that I have a hard time believing that every caregiver in that hospital was a sadist intent to drive her to suicide. That doesn’t mean they were right, but you also have to give some benefit of doubt and adjust for filter and perception.

The day I delivered my daughter, I had the worst post-partum nurse ever. Hindsight, she likely wasn’t that bad, but I was hungry, had really low blood sugar, was worried about my child, wanted to get to the NICU and couldn’t get there quickly enough, and a bunch of other things that colored my perception.

The night I was admitted to the hospital for liver failure, my triage in the ER was absolutely botched. The RN missed several key aspects of my vital signs and exams that should have clued her in to my exceptionally ill state. But I was mildly encephalopathic and so wasn’t in much of a place to judge and never felt the same upset with her that I have with the post-partum nurse, though that triage nurse gave me far worse care and endangered my life so much more than the other one. But at the time I was in the ER, I didn’t think it was serious yet. And when I was in post-partum, I didn’t know that my daughter was ok yet. And that colored my perceptions permanently on those RNs and the care I received. It’s not fair, but it’s how the human brain works.

Monkey Professor for a Head

I’m sure there are lots and lots of good intentions when it comes to lactivism. It doesn’t stop it causing harm, and it doesn’t make it ok.

Charybdis

Then lactivists and lactivist-land are hell. Because the road to hell is paved with good intentions and apparently, all lactivists are full to overflowing with love, concern and other “good intentions” so that everybody breastfeeds.

guest

The end doesn’t justify the means. It’s unethical to hurt a patient in the pursuit of some (imaginary) risk to a baby.

Nick Sanders

“Good intentions”

You know, there’s a rather famous saying about those.

momofone

Well, clearly it worked so well the first time around, right?

Edited to add that in theory I completely agree that having that information should result in conscientious care; however, it’s been established that that wasn’t the case, no matter how many times you repeat yourself.

sapphiremind

It wasn’t the case previously. But if she were open with her caregivers about her last experience, what do you think the response is likely to be. Joy that they made a new mother feel suicidal and horrible? Or that they will bend over backwards to ensure it doesn’t happen again? I know in every situation I’ve been in where a family has had a previous “bad experience” that’s been noted in the chart, we do go out of our way to ensure that bad experience isn’t repeated, no matter what the root cause of that experience was. It comes down to whether you think that the medical team is the enemy or not.

Who?

It should actually be enough for the notes to say ‘exclusively formula
fed’ but if the caregivers feel it is their business to be in mother’s
head, then I suppose the explanation that mother doesn’t wish to is tolerable.

Irène Delse

Well, good for you and the place you work for, but the fact that you still don’t seem to believe what Erin told you (“if she were open with her caregivers”, “it comes downs to whether you the medical team is the enemy”, and other put-downs) doesn’t fill me with confidence in your ability to acknowledge when mothers tell you that they’d rather not breastfeed.

Amazed

If they’re anything like you, then yes, they will rejoice in the way they made her feel. Just like your cowardly, passive-agressive bullying self did when you posted your falsely sympathetic and concerned crap about Erin.

I’ll never understand what perverse delight people like you derive in putting people down like that but here you are.

sapphiremind

What delight am I deriving in this? How am I putting anyone down? I am deriving no delight, believe me. I am sorry she had a terrible experience. As a health care professional though, I do not think it was the intention of every health care professional to torture her and if they had realized it, they wouldn’t have. And if she is proactive prior to her next experience, I think she can ensure better care and make sure it doesn’t happen again, and that just hiding it all is not the best choice.

Megan

Shouldn’t you all be going out of your way to make sure every family’s experience is great regardless of their feeding method and/or why they chose it?

Linden

You’re proving that your profession has people who lack empathy and don’t understand bodily autonomy for women.
Why should she have to disclose extremely personal information which has absolutely no bearing on how she should be treated?
If you respected your patients, a simple note that the mother was not going to be breastfeeding would be enough.
Let’s put out a really simple analogy here. If I don’t want to have sex with someone, I don’t have to tell them in detail exactly why.

Roadstergal

Are you calling rape a “bad experience?”

20 minutes of action, perhaps?

Amazed

Come to think of it, perhaps her suggestion is that Erin should start giving lectures about the dangers of misunderstanding your caring healthcare providers.

guest

She can’t even say the word rape. It’s just a “bad experience,” nudge, nudge, wink, wink.

sapphiremind

No, I’m calling her experience with the hospital personnel a bad experience.

Roadstergal

Hospital personnel pushing their breastfeeding agenda on a woman who’s not breastfeeding simply because she doesn’t want to is a bad experience. Erin’s experience is horrifying and then some, and your inability to have even a single fuck to give about it is telling.

As is your continued insistence that it’s all her fault for not having an I WAS RAPED tattoo across her forehead to let all and sundry know she has what I’m sure you consider a barely-legit reason for not breastfeeding (although really, she should have given it a try, she might have liked it…).

sapphiremind

I never said it was her fault. Nor do I care why she didn’t want to breastfeed. I was trying to explain to others (and maybe Erin) that the medical practitioners were not evil people intent on harming her, nor did they care nothing for her. But that they likely misinterpreted a situation, without having complete information, and in trying to make it better, inadvertently made it worse. Because in my career I have met very few true villains who really want to harm people, and the way everyone else was talking, the medical professionals were being ascribed an intent to cause as much harm as possible.

In the meanwhile, I have been verbally abused and harassed. I doubt that was done with the intention of trying to make me feel good about myself. Or that anyone thought that it was a kind thing to do. Or that it was in any way an acceptable form of debate. I haven’t retaliated. I haven’t called anyone names or insulted them, while members here seem to have a goal of trying to belittle me as much as possible with a goal of … what? Make me feel terrible about myself? Make me suicidal? All because I offered a different point of view of why medical people might have behaved in a certain way. Oh, and because I agree with the WHO and AAP.

momofone

“I never said it was her fault. Nor do I care why she didn’t want to breastfeed.”

You are getting a lot of feedback that says that whether or not it was your intention, it’s how you’ve come across. What strikes me as the point you’re missing is that what they intended may well be one thing, but what they actually did was another altogether. If I head down the street and intend to stay in my lane, but actually drive on the sidewalk, mowing down pedestrians, my intentions are irrelevant; the damage I’ve caused is what’s important. “But I didn’t mean to” rings awfully hollow.

Erin

The thing is, you should care why I don’t want to breastfeed because there are a lot of women like me out there. The specifics of my case are irrelevant but when people talk about breastfeeding and the health benefits there of, they also have to think about the other side. I obviously can’t speak for all rape survivors but I found breastfeeding hugely triggering and I know from what other women have said to me, that I’m not alone in that. Now, I don’t think that caused my mental breakdown but it certainly didn’t help.

So does the benefits of breastfeeding outweigh the risks of triggering mental illness in the Mother with all the developmental problems that can cause? You talk of advocating for the child so that’s a question you should be considering. It won’t be the case (I hope) for most women but it will for some.

To quote from one study on the effects of postnatal depression:

Following up from a large cohort of children over the first two years of life, she noticed long-term consequences which included behavioral problems, difficulties eating and sleeping and problems in forming their own attachments to other adults, including fathers, siblings and peers.

Absolutely women who want support with breastfeeding should get that, I don’t think anyone would argue otherwise. However, I do think sometimes the focus is so much on breastfeeding that the fact we don’t all have wonderful relationships with our breasts gets over looked.

Also I’d add that no where did I say that medical practitioners were “evil people” and nor do I believe that. If I did, I’d be planning a home birth not a hospital one with baby number 2. In fact, I tried very hard to think of alternative reasons why I was being told some of the things I posted here. I failed to find a convincing one other than what I posted in the first place…the push to breastfeed especially in a hospital which makes no bones of their drive to get c-section mothers to breastfeed to improve their statistics.

Amazed

It’s interesting to watch you twist your tail in circles. After all your howling how the people who told Erin that she should have not gotten pregnant if she wasn’t over her rape only had her best interests in mind, now you insist that she needs to be open with her caregivers about her bad experience of being told that by those same caregivers and they’ll suddenly feel awful for being so awful? Could you please set your hypocritical lies in order?

In what universe do such words come across as caring? Only in the one you and your fellow lactivists inhabit.

Amazed

Actually, the asshole’s insistence is that Erin should have told the personnel how butthurt she was that they told her she shouldn’t have had a baby if she wasn’t over being raped. Because those caring professionals – with the asshole’s own level of empathy – couldn’t possibly have known it.

Azuran

No, her rape story shouldn’t be in her medical file and does not need to be known by every one in the hospital.
The only correct way for this to actually go is to ask her ONCE: How are you planning on feeding your baby? Then you put that answer in the medical file and you don’t bother her anymore with the matter. You can ask her if she needs any help or pointer about the feeding method that she chose (and only about the feeding method that she chose, unless asked otherwise). Why she chose BF or FF is none of your, or any other provider’s business.

And here’s a better broken hand analogy:
If I have a broken hand, I’m not holding out my hand for anyone to shake it, and it’s really none of your business why I won’t shake your hand (I might tell you, or I might not, it’s my choice since it’s none of your business and I don’t owe you an explanation), and if you go out of your way to grab my unextended hand to shake it, then you are an asshole not respecting my personal space regardless of if my hand is broken or not.

Who?

The idea that people should be explaining themselves regarding personal decisions is pernicious. It is more than fine to say ‘yes’ or ‘no’ and move on. Unfortunately there is an element in the community (let’s call them busybodies) who don’t respect that choice, and those people need this explained to them in words of one syllable or less.

sapphiremind

Not everyone in the hospital, but those who care for her absolutely do need to know about it, because it is pertinent to her OB/GYN care.

If you want to continue with the broken hand analogy in this way, if you chose to not tell anyone anything and just stare in stony silence, you can expect to potentially be misread or misinterpreted in your body language or behavior because it is a social norm to shake hands and if you don’t, it is typically considered polite to give an explanation why it is not intended as a personal slight.

For example, I was getting a migraine. I was talking to someone in polite, direct, civil terms, but not adding much emotion or anything because I was getting a migraine and was in a lot of pain. Later I found the person thought I was being rude to them because I wasn’t behaving warmly and thought I was being aloof and business-like to her on purpose because I didn’t like her. She was upset until she heard the explanation that I was in immense amounts of pain. Did I owe her an explanation? No. Did it make it better that I gave her one? Absolutely. It’s not equivalent, I know that. But communication with caregivers goes a long way.

momofone

As she said, though, her OB is aware, and the hospital is as well, to the point that they have made accommodations for her should she be in need of OB services again.

Erin

My OB knows yes as do some of her colleagues given all the issues I had getting the birth plan from hell approved (her words not mine) but it’s not something I want made common knowledge because of the way people treat you when they find out. I’m not a brittle little doll (most of the time) and I hate being reminded of what he did to me.

Plus as I think this conversion has illustrated there are plenty of people out there who think that rape related trauma isn’t a good enough reason to not breastfeed when you have a good supply. Having that argument in the hours after having a baby is not acceptable in my opinion.

guest

I’m sorry that Sapphiremind is so dense, Erin. Just know that there are so many of us here who think you deserved much better treatment.

Azuran

And if you ask why I won’t shake you hand and I say .’I don’t want to talk about it’ then you should just leave it at that.
It’s up to me to decide who I want to talk to. And it’s the same to any rape victim. If she feels that it would help her for her OB or some nurses to know, then she should tell them. But the amount of trauma varies in people and some people would rather not anyone but the OB knows, and others just don’t want anyone to know and feel they can go through it on their own.

And we are talking about rape here, not a broken hand or a migraine. Simply having to think or talk about it is often very hard on rape victims. And it’s not a candid discussion in the street. It is not medically relevant why a mother doesn’t want to breastfeed.

guest

Do you not understand how telling people you were raped is different from telling people you have a migraine? I’ll sing it from the mountaintops “Hey world, I get migraines!” and have only maybe a little fear that it might affect my employer’s perception of me. If I were raped, each time I had to tell someone would be potentially embarrassing and painful to me, and cause me to remember the rape again, and be just generally speaking BAD. Your lack of sympathy (never mind empathy) is appalling.

Guest

As a rape survivor, it is NOT “polite” nor should it be expected that I tell an entire care staff my personal story. Unless I am seeking care for the rape, I should NOT have to explain my personal history in order to have access to empathetic care. That’s insane. And it shouldn’t be a “social norm” to expect a person to breastfeed and need to explain why they don’t want to or are not able to breastfeed. I say this as someone who has breastfed FOUR children and supports women in their desire to breastfeed or formula feed.

Elizabeth A

And to be clear – explaining to every. single. hospital. employee is the only way to get the information across. It has been my experience that staff read the first page of the chart AT MOST. So by the time a woman gets to the post-partum floor, odds are good that the “patient is rape survivor” note that she discussed with her OB in the first or second trimester is just not pinging anyone’s radar.

I’ve had this issue in oncology – I have failed breast reconstructions, I have no interest in going for more attempts, it upsets me to discuss it, I have discussed the issue with my oncologist and his NP, it’s in my chart… and in a routine follow-up appointment, I typically have 2-3 people ask me if I would like to hear about reconstructive options or get a new referral to plastics.

demodocus

After my first’s birth, freaking everybody talked to us about birth control. I could see how another couple with fertility issues could become very upset about having to repeat their condition over and over.

Dr Kitty

I have a more than one patient with a first IVF pregnancy and a very unexpected natural conception shortly after the birth of their first.

Obviously, those couples tend to have unexplained infertility, low sperm count or anovulation, but I’ve seen it happen enough times that I still prefer to at least raise the subject of birth control.

demodocus

Of course. But that’s once or twice, not 6 or 7 times

Dr Kitty

Oh…
No, that’s not so good.

Daleth

Not everyone in the hospital, but those who care for her absolutely do
need to know about it, because it is pertinent to her OB/GYN care.

How is it pertinent? All you need to know is what she wants and doesn’t want. If she wants a c-section, it’s not your business that the reason she wants it is because she was raped and doesn’t want to risk having flashbacks during labor. It’s not your business that the reason she wants no vaginal exams but just a c-section the minute labor starts is because she can’t bear some stranger’s hand inside her.

It is NOT your business WHY she makes the choices she makes. It is simply your job to respect her choices, at least as long as they’re reasonably safe (e.g. a c-section is a perfectly safe option, so shut up and respect it; refusing vaginal exams is perfectly safe if she’s ok with other methods that check the position and descent of the baby–maybe ultrasounds for instance; etc.).

sapphiremind

Because you are not a medical professional and there are all sorts of other decisions that come into play beyond just the patient showing up and dictating exactly what care they are going to receive. If that were the case, there would be no need for medical professionals at all. It is important for the medical professionals taking care of her to know her medical history so they can properly take care of her. If she chooses to withhold that information, they will not give her proper care.

Nick Sanders

A word of advice, around here it is unwise to assume people are not medical professionals.

sapphiremind

I assume many people are, but I also know that a medical professional would also know that the patient does not come into the office and dictate off all their care. It is a discussion and the provider needs to know the medical history and sometimes the psycho-social history that contributes to that. Because while the patient is the one who has to consent to the procedure, the doctor is the one who has to perform it. Even for elective c/s, they frequently will suggest laboring first, because there’s some benefit to it, if there are no contraindications. There are many medical decisions that get made that the patient isn’t just given a menu.

Megan

But presumably the baby is your patient (since I believe you said you are a NNP). Why do you need to know mom’s reason for not breastfeeding?

sapphiremind

I won’t – it won’t be me dealing with the mom to ask.

Nick Sanders

It is a discussion and the provider needs to know the medical history

In this case the proper discussion is “Are you considering breastfeeding, formula, or combo?” And if the patient says “formula”, there is no history to take, and any further discussion is limited to proprer storage, preparation, and sanitation.

There is no “procedure” for the doctor to perform. Your ridiculous comparison to a c-section is just more shameful dishonesty on your part. I have no idea how you compared food to freaking surgery with a straight face. You’re very much reminding me of the person from last week who went on the crusade of lies against epidurals, spouting constant bs refrains about informed consent and fetal respiratory distress.

Azuran

Proper care would have been to let her make her own decision regarding feeding her baby and to respect it.
We are talking mainly about BF here. There is no situation where any nurse, or midwives, or lactation consultant or even an OB or whatever needs to know that her reason for not BF is rape. None whatsoever, it is not medically pertinent in any way.

The only medical professional who might have a need to know about a sexual abuse history is the OB in charge of her case, for the purpose of making a birthing plan with her (and the person who originally shared her horrible experience did talk about it with her doctor). And then, he only needs to share the ‘plan’ with the nurses and LC and stuff, not the reason behind it. And the nurses should follow this plan and care for their patient with the same care and respect they would treat anyone else.

Dr Kitty

I have patients who have INCREDIBLY sensitive medical histories.
The kind of history that means we write almost nothing in the computer notes and set the access settings so that only the doctors can read any of it.

I have patients who request that certain aspects of their medical history aren’t shared with other professionals.

I have patients who request that certain things aren’t documented at all.

Patients have a right to privacy.

How about, rather than insisting that all women who find breastfeeding triggers past trauma disclose said history of trauma, that you assume than any woman who doesn’t wish to breastfeed, or who stops breastfeeding very quickly *might* have a history of trauma which she *might not* want to discuss.

Kind of like you take universal precautions when taking blood because you assume every patient *might* have a blood bourne virus and *might not* want to disclose it.

An Actual Attorney

Given that the likelihood of a woman having been sexually assaulted or abused is something like 25%,last time I looked, it seems like an obvious universal precaution to assume that any woman has that history.

guest

Lactivists like you are like telling someone you have a broken hand and therefore you can’t shake hands, and they grab your hand to shake anyway without asking and say “It’s just a variation of normal. Keep shaking hands it will get better.”

Charybdis

I call “shenanigans” on the statement that their intention is not to harm. Their intention is to support, educate and bully people into breastfeeding, period. All they care about is that the baby is plugged into mom’s boob as often as possible, nonstop is better.

Dr Kitty

No, it should be in her chart *if she wishes to disclose it*.

In my second pregnancy, after a previous planned pre labour CS for multiple soft indicators, which was very much supported by my now retired OB, I got the full NHS “why don’t we try for a lovely VBAC”.
Not ONE mention was made of any possible negative outcome of vaginal birth or VBAC, lots of “shorter recovery time”, “avoiding major surgery”.

I kept saying that my preferred plan was ERCS at 39w and immediate EmCS if I arrived in labour prior to that, and that I would not consent to any kind of induction or TOLAC because I felt the risks were unacceptably high.

After a lot of “well, sure, if you show up in labour, we’ll just play it by ear”, I eventually lost it, and explained, in detail, that the several hours I had spent as a junior doctor assisting in the emergency CS for a uterine rupture during an attempted VBAC, which turned into an invocation of the massive transfusion protocol and an emergency hysterectomy ( the baby died) were indelibly fixed on my memory and when I said that the risks of TOLAC were unacceptable to me, I meant it.

Now, I shouldn’t have had to explain that, should I?
As a doctor, there shouldn’t have been any question about my knowledge of the risks and benefits of ERCS bs VBAC, should there?
Nobody ought to have doubted my capacity to make medical decisions, and YET, they did.

That rupture didn’t happen to me, that baby wasn’t mine, the risk of rupture in my case was no higher as a result… But suddenly “NOT FOR VBAC- FOR CS ASAP IF IN LABOUR” was put on my notes.
It should have been there long before that.

I get people want to know why patients make certain choices,but that is curiosity, it isn’t actually clinically necessary unless you think that they are psychotic or incompetent.

Nothing changed for my care providers, except that they suddenly believed me when I said VBAC was unacceptably risky *to me*.

Even with patients you’re pretty sure sure making terrible choices for bizarre reasons (jehovahs winesses, anti-vaxxers), they have a right not to discuss why they’re making the decision they are.

Charybdis

Don’t forget the anesthesiologist who tried the “you don’t need painkillers after surgery” line of BS on you.

Why does it seem that when you (general you) have had *enough* and then explain, in great detail, exactly *WHY* you have issues with x,y, and/or z, the people doing the pushing/questioning get all hurt and defensive? They are the ones pushing the issue and they have the gall to act like they are the injured party.

Dr Kitty

Ah yes, the one who tried the “maybe if you don’t expect to feel pain, you won’t feel it” line, and who told me that maybe I should educate myself about what a CS involved so I wouldn’t be so anxious, because anxiety increases pain…this was before my SECOND CS, both of which I had actively chosen.

Not enough rolleye emojis in the world for that nonsense!

I admit, watching him realise that he had seriously misjudged his audience was almost worth the annoyance. He was a redhead- you could have fried an egg on his face. I am a bad person.

Nick Sanders

maybe if you don’t expect to feel pain, you won’t feel it

Are you entirely certain you were dealing with a human being? Because “unexpected pain” is very near the top of the list of frequent problems with the human condition.

Daleth

I will say, if you don’t mention any of your past trauma to your
caregivers, they are not able to give you optimal care. They will
continue to seem pushy because they won’t know of how it affects you.

Wait, what? Women have to tell you they were raped in order for you to stop being pushy about how they should use their breasts?

How about you just stop being pushy, period? It’s not only women who have been raped who find pushiness hurtful and offensive.

Dr Kitty

I think women should just say “breastfeeding is against my religion and I cannot discuss it any further with those outside my faith. I take any attempt to change my mind as gross disrespect of my sincerely held religious beliefs”.

Those lovable little scamps!
Epic trolling, and exactly who I was thinking of.

CSN0116

If there are babies being hurt by improper formula feeding in the United States then SHAME on medical professionals and their professional organizations. Proper formula education, coupled with all of the luxuries within a developed nation, should result in zero formula injury.

Charybdis

“The first rule about formula feeding is ‘not to talk about formula feeding'”. Because if nobody talks about using formula, how to choose a brand, how to mix it, the difference in powdered, concentrated and ready to feed varieties, what water to use, etc, then women will not think to ask about it.

Ignoring an option, or hoping that it will just go away will not make it less of a valid option.

sapphiremind

Same about babies harmed by improper breastfeeding.

CSN0116

Yes… obviously…

Box of salt

Healthy mothers don’t matter then?

sapphiremind

They do. Can’t have a healthy baby without a healthy mother. But I do advocate for the health of the baby.

Box of Salt

sapphiremind ” But I do advocate for the health of the baby.”

The pushback you’re getting here is from those who are advocating for the mother, because that benefits the baby as well.

Why can’t you advocate for both?

Who?

Of course you can have a healthy baby without a healthy mother. Or the other way around.

Charybdis

Obviously not as much as breastmilk and breastfeeding does.

denise

Wonderful. So really, it is none of your business where mothers decide to spend their hard earned money. And the extra 700 calories a breastfeeding mom needs doesn’t appear out of thin air. Law of thermodynamics and stuff.

Azuran

If your game is healthy babies. Then why are you even wasting every one’s time.
Have you ever seen a term baby get injured by properly prepared formula? Got any proof of that?
If you truly cared about babies you would see that both BF and FF are perfectly acceptable way of feeding a baby and would support BOTH mother who want to BF and FF or combo feed equally.

Nick Sanders

Reminds me of the claims about revenues from vaccines which ignore the percentage of total revenues they actually represent for the companies that make them.

denise

Could you please provide statistics on term babies that were fed with formula that meets standards and prepared with safe water, respecting instructions and harmed because of formula? I suspect the number is close to 0. Now, how about babies that have suffered under the BFHI? Hypoglycemic babies? Babies with jaundice? Excessive weight loss? Hmmm. That must be sooo rare.

sapphiremind

Some of these statistics though for breastfeeding are not for “correct” breastfeeding with respecting instructions etc. If you are talking about diluting or adulterating breastmilk, that’s not acceptable and just as many people do it to formula as they do to breastmilk (if not more)

There are infants we see with hypocalcemic seizures because of hyperphosphatemia at around 7-14 days of life who are receiving formula. There appears to be either some environmental or genetic risk factors, but it’s not fully known yet.

Although rare, it is possible for full term infants to get sick with NEC 🙁

The mistakes with formula are not zero and should be included because arguably much of what is being seen and discussed here are mistakes with breastfeeding because if the child is being appropriately monitored, having stable glucoses, voiding and stooling appropriately, the risks are similar. All babies have weight loss after birth. It’s important actually for them to have that weight loss, btw. And pathologic jaundice happens to formula and breastfed babies alike.

Formula is not the devil and it is nor poison, but it is not *superior* to breastmilk and breastmilk should not be gotten rid of in favor of it.

denise

What are your statistics? I want numbers and sources. Is formula superior? In my *personal* opinion yes, can be. But really, quality formula, prepared the correct way, respecting all instructions, it is the equivalent of breastmilk, provided Bm exists in sufficient quantities, and assuming the baby can latch. The BFHI that has the “abstinence only education” approach to formula is the reason behindf ormula injuries. Also excessive weight loss and starvation induced jaundice is what I am speaking of.
It sounds like you are admitting that BFHI is incompatible given current resources, including those of developed nations and/or the order for IBCLCs does a miserable job with the educating and preparing lactation consultants.
And who said anything about abandoning breastfeeding?

sapphiremind

If you give people two options and say “They are entirely identical, but one requires no extra work or learning or effort from you, the other is going to be harder to learn, but confers no benefit” (which is what Amy is claiming) it will lead to more and more people abandoning breastfeeding entirely.

As for citing, I’m going to just go with the WHO – it’s a commonly accepted fact at this point, except by some, that breast milk is superior to formula. Now, it is only superior when there is breastmilk present to give. I’m always in favor of feeding the baby – baby hungry, feed it. Formula is not poison. But it is harder on the gut. And it isn’t designed for humans. It’s great as a backup when there isn’t milk available, for whatever reason.

guest

So what if more people do abandon breastfeeding?

sapphiremind

You have more preterm infants potentially being injured. And while the benefits of breastfeeding are modest, when you amplify them across the entire population, it does grow.

CSN0116

Bull shit. The (pathetically modest) effects are contained to the first year of life. Do one, good study that controls for daycare use, in addition to SES, and that shit will poof — disappear.

sapphiremind

I don’t agree. Amy has decided she knows better than the medical establishment on this issue, but I’m sticking with them.

CSN0116

You have read the papers (not the abstract s) used as evidence by the AAP and WHO and walk away impressed?! They’re utterly underwhelming and most often the methodologies are totally fucked up.

I don’t listen to Amy, just found her a year ago, but the evidence used by the organizations themselves do not show clinical significance to promote breastfeeding whatsoever. READ THEM. They show, “Meh, do what you want … Oh, and make sure you’re not poor; it’s bad for the health of your baby.”

Azuran

The thing is, the effect of BF are indeed very modest (putting aside preterm babies) and in the long run, will have absolutely no effect on how anyone turns out as an adult.
No one out there can say that they failed at anything because they weren’t breastfeed, or that they would be healthier or more successful if their mother had breastfeed them. No one, not even doctors and scientist with all the testing they would want to do, are able to tell if you were FF or BF. Or even look at a different populations and figure out which ones have the highest rate of BF
Breastfeeding ends up being only a very small portion of everything that is going to define anyone’s development. And when compared to things such as parents genetics, the health and weight of the parents, the socioeconomic status of the parents, education of the parents, what you feed your child ALL his childhood, what kind of school he goes to, what neighbourhood you live in and the method you use to raise your child, BF or FF is really low on the list of things that really matter.

As such, anyone who wants to breastfeed should get all the help she needs as long as both her and her baby are healthy. But there is no need to make even 1 woman feel even slightly bad about her choice not to breastfeed.
And letting a newborn baby lose weight and get dehydrated is probably more than enough to negate all the benefits of breastfeeding. It should never be allowed to happen.

guest

No. We’ve already said it’s important for preemies. Acknowledging the not every mom wants to or can breastfeed has nothing to do with special needs. When a premature baby is born, the neonatologist should counsel the new parents on the risks of formula *early on* and discuss the feasibility of providing breast milk, whether from the mother or a bank. The end. Acknowledging that all other babies can have either kind of food and it makes no difference as long as they get enough has no effect on what happens in NICUs. It’s the difference between sick babies and well babies – sick babies can and are treated differently, and their parents counseled differently. We don’t give general advice on the basis of “only a small number of sick people need to follow this protocol, but we don’t want people getting confused.”

sapphiremind

Just out curiosity, where do you think human banked milk will come from if all term mothers abandon breastfeeding?

Nick Sanders

Is there a point to using hypotheticals that will never, ever happen as if they were some sort of argument?

sapphiremind

Because the argument was “so what if every term mother decides to formula feed?”

Nick Sanders

Don’t lie.

sapphiremind

“So what if more people do abandon breastfeeding?”

Nick Sanders

Like I said, don’t lie.

“More” is not “all”, it’s not even necessarily “most”.

guest

And as the person who wrote the quoted sentence, I can assure you, I did not mean “all” when I wrote “more.” I meant more as in, “more than now, but not all, because if I meant all I would have said all.”

Charybdis

What if they did? It would end the battle once and for all. Babies would get the nutrition they need, when they need it; no guessing if they were getting sufficient food to grow and not starve or have damage from chronic underfeeding.

Sounds good to me.

Roadstergal

Ah, if we lived in a world where only moms who really wanted to breastfeed and to whom it came easily would breastfeed/combo feed, and all babies would be fed!

What a terrible world it would be.

sapphiremind

Except for the preterm babies who would die from lack of breastmilk.

guest

Greater or fewer babies than are dying and damaged by inadequate breast milk right now?

Charybdis

But what about their mothers? Or are they somehow now exempt from pumping for their preterm babies? Because not ALL breastmilk is protective against NEC, so formula will continue to be an option for both preemies and term babies.

Monkey Professor for a Head

When my son was born, I knew that whilst there were some benefits of breastmilk, they were small for healthy term infants. I still breastfed him, as I had a good supply, I wasn’t working, and it worked out easier overall for me. If my supply hadn’t been adequate, if I had gone back to work, or if breastfeeding wasn’t working out for whatever reason, I would have combo or formula fed as appropriate. I wouldn’t have killed myself trying to breastfeed at all costs. Is there anything wrong with that?

You may not intend it, but what you are basically saying is “If we give women accurate information then they might not make the decision that I want them to make”.

(I did consider donating to a milk bank as I had a bit of an oversupply, but as far as I could tell from the (not very informative) milk bank website , the rules of donating were the same as for donating blood which I couldn’t do for several reasons. I was too wiped out by anaemia and sleep deprivation to pursue it further.)

guest

“So let’s lie to women so that they will do what I want. And we’ll use the specter of dead NICU babies to guilt them.”

Such a loverly person, Sapphiremind is.

corblimeybot

Who cares, since that would never actually be an issue, and is a boogyeman you summoned up out of overblown contrariness.

Who?

Why would all term mothers abandon breastfeeding?

Roadstergal

*crickets*

Lawd forbid she hangs out to hear the stories of the women here who breastfed despite knowing the negligible benefits of breastfeeding vs formula, because it worked for them and they wanted to. Like Dr T.

Megan

Hey, if she’ll gaslight Erin, I don’t want to see what she’d say about a lot of the stories from commenters on this site.

Elizabeth A

Preemie moms with oversupply.

There’s very little risk of all term mothers abandoning breastfeeding, but given what a pain in the ass pumping is, and the stringency of donor requirements, milk donation is pretty rare anyway.

sapphiremind

Most preemie moms use all their milk. They have a hard time ever getting their children to go to breast and eventually quit pumping and so go through their freezer supply. Most donations are from term mothers with oversupply. Or mothers whose children died without being able to use their milk. Milk donation isn’t as rare as you might think, depending on how active the milk bank is.

But if it comes down to everyone assuming that other mothers will pump extra to provide for their baby in case of need, there will never be enough to feed all the babies, much less to make human milk based fortifier.

Elizabeth A

But the same is true of most full-term moms – they use what they produce. It’s a relatively rare woman who has the supply and dedication and TIME to pump more than she needs, store it so it can be donated, and keep pumping when she is no longer feeding her own children. Oversupply is a problem to be resolved, not an opportunity for generosity.

Basically, as long as woman aren’t dairy cows, donor milk is tough to come by.

(Also, let me question the utility of oversupply. I had oversupply – including with my preemie. We lived in foremilk/hindmilk imbalance hell. Some of my milk was so watery that it was nearly transparent, and pale green.)

(I was never eligible to donate because I spent the wrong year in the UK in college.)

guest

I was a preemie mom with twins and could have supplied two more newborn preemies with milk. But my NICU nurses told me milk sharing was illegal in my state.

I mean, since you like anecdotes as evidence so much.

Charybdis

You should talk to BeatriceC. She had preemies, and a massive oversupply. She had something like 50 gallons in freezer storage.

There will never be enough pumped milk to develop human milk based fortifier because if most preemie moms use all their milk and those with term infants often don’t want the hassle of having to pump extra, then there will always be a scarce supply of breastmilk in a bank.

Now, if they could figure out a way to genetically modifiy dairy animals (cows, goats, sheep, horses, camels, etc) so that they would produce human milk, that *might* help make up for the dearth of human milk in banks. But then that major scientific breakthrough would be met with “Hell no! No GMO’s” chants, picket lines and such, even if it would solve the shortage of human milk in milk banks.

guest

What kind of idiot are you? Even in the 1970s “all” mothers didn’t abandon breastfeeding. NO ONE here is advocating the end of breastfeeding. We’re just looking for women who choose or need formula to be respected for their choices, and for rhetoric of “liquid gold” to be toned down until it’s *accurate* instead of hyperbolic.

In fact, if more women understood that formula is not the devil, there might in fact be *more* banked milk available if some women who are currently doing informal sharing to get their charity jollies turned to donating to banks instead of random people with healthy full-term infants who are convinced their baby will lose IQ points if they have to supplement two bottles a day. (It would also help if the milk banking process could be made more convenient to the donating mother – perhaps lactivists could focus on doing that instead of on shaming mothers of healthy babies).

Charybdis

Breastfeeding has never been abandoned, ever. The rates have dropped dramatically in the past, but the rates have never dropped to zero.

Banked milk will come from the place it is currently coming from: mothers with oversupply who wish to donate. Making breastfeeding mandatory, for all practical purposes, will NOT increase donations to a milk bank, nor will it make accessing banked milk easier or less expensive. It will only anger and upset people.

Irène Delse

If nutritional advice for the general public followed the lactivist rules, peanuts would be banned for everybody because some people are allergic. And it would be illegal to order a steak in the restaurant without an accompanying serving of vegetables (no fries!). And if you want ice cream for dessert, a Dental Consultant will check your teeth to ascertain if you can chew properly and eat the more healthy option, fruits.

See? Health is so simple to achieve if people only gave it a try!

Roadstergal

“And while the benefits of breastfeeding are modest, when you amplify them across the entire population, it does grow.”

That’s such an excellent point! That’s why people born in the ’70s – when breastfeeding rates hit the nadir of about 30% – have so much more obesity, allergies, asthma, and other chronic health conditions than people born in the decades since, when breastfeeding rates have risen dramatically to the 80% range!

Oh, wait.

Azuran

Well duh. Obviously my mother’s obesity and diabetes is a direct result of her being formula fed and not because she’s obese, doesn’t exercise, eats badly and her dad is also an obese diabetic. (I might also add that even though she breastfeed 3/4 child, she only got bigger and bigger with each pregnancy and was never able to lose the weight)
But yea, everyone should breastfeed because that’s what REALLY makes a difference.

Daleth

You have more preterm infants potentially being injured.

Well, no, because for preterm infants, BM and formula are not currently identical, and at the population level there is a benefit to BF’ing preemies. (I say at the population level because as you saw from the studies some others here posted, some women’s BM is deficient in certain compounds, and since it’s those compounds that apparently help prevent NEC, those women’s breastmilk won’t help prevent NEC in their babies).

Charybdis

There will be panic in the streets, mass riots, great civilizations will crumble, people will lose IQ points at an exponential rate causing the future generations to become dumber than a bag of hammers and mankind’s girths will expand until we are all a nation/world of lethargic whale slugs who don’t have enough sense to come in out of the rain and, as a result, drown when they look up to see where all the water is falling from.

/sarcasm

Nick Sanders

Forty years of darkness! Earthquakes, volcanoes… The dead rising from the grave! Human sacrifice, dogs and cats living together… mass hysteria!

That sort of thing NEVER happens with breastfeeding, ’cause it is PERFECT, don’tcha know?!

Breasts are magical, magnificent, morphing milk bags that, on a second’s notice, can manufacture an exquisitely controlled, ambrosia-like elixir tailored specifically to the baby in question! Never too much, never too little! ALWAYS perfect, instantly taking on and destroying any and all infections threatening your baby! Always on hand, never needs messy mixing or irritating clean up! But wait! There’s more! Act now, and you will also receive a support pillow to make nursing more comfortable, and TWO coordinating covers for the pillow. Plus an attractive tote bag to carry the pillow and any baby supplies you might need when you leave the house. **

**Batteries not included, blood and pus in your breastmilk will not hurt your baby, continue to breastfeed if you have mastitis, bloody, raw nipples and/or thrush.

CSN0116

Your words …so flowery …so beautiful! I’m sold! 😉

Charybdis

It’s good for “colds and moles and sore elbows! Itches, twitches and slippin’ of the britches! Thin as a shadow, but strong as an ox! Available on demand from a lactating mother!” **

**This information has not been evaluated or approved by the FDA and is not necessarily based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general wellbeing and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.

Roadstergal

Seriously, if you’re only breastfeeding because you’ve been lied to about the benefits of it and the risks of formula, you SHOULD abandon it!

guest

I reached a point where the only reason I was still breastfeeding was because I’d been lied to (by various internet websites and articles) about how important it was to do it for 2+ years.

denise

“As for citing, I’m going to just go with the WHO” meaning you don’t have any statistics regarding formula injuries, particularly when instructions are followed, and formula meets the standards. Ok, fine. What was the starvation jaundice rates in the US of breastfed babies, again? 10 to 18% according to the Academy of Breastfeeding Science. And safe to say, thanks to the no formula within the first 24 hour policy, a good chunk of it happens even before discharge.

denise

Breastfeeding Medicine* my apologies

denise

‘”They are entirely identical, but one requires no extra work or learning or effort from you, the other is going to be harder to learn, but confers no benefit” (which is what Amy is claiming) it will lead to more and more people abandoning breastfeeding entirely.’
And that is really none of your business. Since you treat feeding injuries, you should be a lot more concerned with the push for exclusive breastfeeding.

corblimeybot

It sounds like you’re admitting that breastfeeding is a miserable, counterproductive pain in the ass for lots of people. You’re just saying that women should be lied to about the benefits, because they can’t be trusted to decide what’s right for them.

Sarah

On what planet is formula not designed for humans? Designed for humans is precisely what it is!

Azuran

All things being equal, breastmilk is slightly better.
But all things are never equal. So whenever BF is not possible for any kind of physical reason, any mental reason, any monetary reason (sad, but it’s often the case) Or just because the mother doesn’t want to breastfeed, then formula is a safe and perfectly good way to feed your child.
You might be able to see slight effect on a population level, but it will not have any noticeable effect on any individual child.

Daleth

If you give people two options and say “They are entirely identical, but
one requires no extra work or learning or effort from you, the other is
going to be harder to learn, but confers no benefit” (which is what Amy
is claiming) it will lead to more and more people abandoning
breastfeeding entirely.

Um… so what? If they were identical, then who cares which one moms choose?

Roadstergal

“But it is harder on the gut.”

Definition of ‘harder’ and citation for said clarification needed.

Sarah

I do believe that was her way of saying statistics, I don’t need no damn statistics.

sapphiremind

Actually, it’s my way of saying: The AAP and WHO have done an exhaustive job on the statistics, I defer to them. But you’re smarter than them, so I shouldn’t bother with anything else. Because even if I found a study, I’m sure it wouldn’t stand up to your standards.

I am about EBM. That includes hospital birth and breast milk.

Sarah

Another way of saying statistics, I don’t need no damn statistics then.

If you’re so confident that the AAP and WHO have done the exhaustive job you claim, you post the stats. There won’t be any possibility of them not being up to our high standards, because they’re so exhaustive. If they can be pulled apart, that’s a hint that they’re not as robust as you think they are.

I am about women being trusted with the evidence. That includes things you don’t like and/or understand.

sapphiremind

Go ahead and go to the WHO page and pull it apart. Have at it. Same with the AAP.

Sarah

Afraid not. You make the claims, it’s up to you to back them up and tell us why it’s all as robust as you reckon it is. Otherwise, this is still ‘statistics I don’t need no damn statistics’.

Daleth

Formula is not the devil and it is nor poison, but it is not *superior* to breastmilk

Actually it sometimes is, and I don’t just mean it’s superior when a woman can’t produce enough BM for her baby to thrive. Some women’s breastmilk is deficient in vitamin D, and if they EBF, their babies will develop rickets. This is not just a theoretical problem:

The breastfeeding industry is making a lot of profit. There are only two ways to feed a baby: formula or breastmilk. Or a combination of the two. Breastmilk *is* beneficial in preemies for NEC reasons, but not all breastmilk has preventative properties. So it is not an absolute that breastmilk prevents NEC.

The EBF brigade claims all the time that breastfeeding is free and that no extra equipment is needed. Mom, baby, breasts = free breastfeeding. It is pretty naive to think that there is no profit in the breastfeeding industry.
Nursing bras, tops, covers (if you are a coverer), milk storage bags, nipple ointment, nipple shields, gel inserts for nursing bras, nursing pads for leakage, pumps, pump parts, pump cleaning and sterilizing products, nursing pillows, SNS systems, extra freezers to store pumped/expressed milk, supplements (herbs, domperidone, mother’s milk tea, etc) wraps/carriers so baby can breastfeed while being worn, scales, LC and IBCLC fees (because they don’t work for free, out of the kindness of their hearts), multiple appointments with LC’s/ IBCLC’s to work on issues, tongue/lip tie revisions, not to mention a few bottles for pumped milk, and other baby paraphenalia. Not to mention the mother’s time is not “free” for her to nurse on demand and/or pump at work, sleep deprivation if the baby “reverse cycles” to breastfeed all the time when mom is home from work, etc.

It is disingenuous to portray breastfeeding as “free” and somehow a “Not For Profit” industry. They are making sure they are getting their slice of the economic pie.

sapphiremind

Well, all breastmilk has those preventative properties, it’s just that not all babies need those preventative properties. I will say I’ve work in a NICU and the year we eliminated all formula for our preterms, including for fortification, we also eliminated NEC. It was amazing.

You can buy all those things, but you don’t *have* to buy all those things. that’s like saying you can’t have a baby if you don’t have a perfect decorated nursery with matching sheets and curtains. I had a couple preterms and one I had to finger feed for a couple days, which was hell, I bought a boppy pillow (well, someone bought me one) and I bought a sling. They didn’t make nursing bras in my size (I’m too small chested :/) Maybe a box or two of nursing pads, though I remember just tending to leak everywhere because I must have forgotten about them a lot.

So, yes, you can end up with a fair amount of expenses, depending on your situation. You can also end up with almost none. It depends on your situation. Largely though the people who are promoting it though are doing so because of the public heath benefits. That’s why the government and WHO etc advocate for it.

Elizabeth A

The year you eliminated absolutely all formula for pre-terms in the NICU, what did you see besides reduction in NEC?

Let me be combative here, as the mother of a pre-term infant, who received breast milk fortified with both formula and additional vitamins.

In the NICU, I watched mothers of very new infants stagger in after the end of the business day, still in their work clothes, lugging their breast pumps, to see their babies. They were trying to save their fmla leave for when the baby came home. They didn’t always pump enough breastmilk. Donor milk was not always available. It was not always covered by insurance.

I saw women sob over breast pumps. I did a lot of that myself. Mothers of pre-term infants are not necessarily in good shape. NICUs are built to meet the needs of babies and medical staff, and parents have to sort of wedge themselves in. We can’t necessarily take care of our own needs while we’re there. Need a chair? Go hunt one down and drag it to the bedside. Need a breast pump? Check it – there are 8 on the unit and 5 of them work. Need to eat? Not on the unit you don’t, no food at bedsides, parent lounge has a table that seats two, so yeah you had abdominal surgery last week, and everyone wants you to pump a ton of milk, but lunch is a sandwich you ate standing up. Need to pee? Bathroom is outside the unit, down the hall and around the corner by the elevators.

This was a world-class NICU. We were lucky to be there. We got our daughter out of it, and I would do it again if I had to. But I came out of it with crashing ppd, and was basically unable to work for a year. We managed, but not everyone can. Formula helped.

Anyone who has children in the US is basically on their own, in terms of social support. Parental leave is scant where it exists at all, usually unpaid, pretty commonly unavailable. We lean on what helps, including formula.

Guest

OMG, it sounds like you were at the same NICU I was. No chairs by the incubators, and a 1 day post-c-section mom is supposed to find it herself and drag it over (basically exactly what you’re told NOT to do for six weeks post-op).

sapphiremind

We had a strong milk bank to provide for any mother who couldn’t/didn’t have the milk to provide for her baby. Insurance coverage isn’t an issue. Unfortunately we can’t control the not eating at the bedside – that’s an OSHA thing.

I don’t know the other statistics of hospitalization days, days on ventilator, etc, just because those are much more in-depth to count, analyze, and review. Not having any inborn patients with NEC is just something that everyone knows and sees.

But I don’t see the reason to be combative – eliminating formula was the medical people’s job, not the mother’s. In order to do that, we had to have the milk bank to support it, the human milk based fortifier to fortify it, and the equipment and support for the mothers to be as successful as possible who were pumping. You didn’t have that, so you gave the next best thing. I agree with a lot of the issues you had – little leave, little support, etc. But that’s not the fault of the milk. We need to lobby our politicians to change that, no matter how we feed our children.

Elizabeth A

I feel like those less obvious measures need some examination though. Obviously, we want to cut down on NEC – yes! Absolutely! – but we also want to be thoughtful about how the tactics we use to do that have side effects.

And we want to look at non-obvious things, like the level of complication handled by that particular unit, the number of NEC cases seen in an average year vs. the year of no formula, the use of parenteral nutrition, approaches to feeding difficulties, morbidity and mortality of the unit, AND the solution can’t just rest on “well, moms will do it,” with fretting about how to convince women to breastfeed and no accompanying consideration to how to make it easier.

sapphiremind

It was a dramatic drop once formula was gone (it has remained gone) I do know that days on parenteral nutrition has dropped but overall morbidity and mortality of the unit is difficult to assess the impact because the preemies are only a small (pun) portion of the patients they see.

Like I said, we had a strong milk bank support and other support in place, so when/if mom needed to stop pumping, there was milk for the baby. Once the child hits around term, cow’s milk protein gets introduced if mom is not providing breastmilk herself (because the baby can’t go home on donor) but by then the biggest risks of NEC are gone. But it can’t be just with the moms.

Looks like we did a study looking at the other rates. Morbidity and mortality on all designations went down when we switched.

Roadstergal

This paper directly contradicts what you said above: “all breastmilk has those preventative properties.” Clearly, if you read the paper, that isn’t the case. Babies fed on the breastmilk-only protocol developed NEC.

What’s interesting to me is Figure 1. Although the incidence of NEC is reduced (again, not eliminated), that’s not a difference between mortality (not a p-value like that with that many comparisons).

My next question was to ask you “Oh, so nothing changed in the management of preemies in the 2006-2008 range vs 2009-2012?” But they already started to give that up in the Discussion: “It is also acknowledged that at the time of the feeding protocol changes, there was increased awareness of central line infection initiatives to decrease central line associated bloodstream infections, which may have contributed to a reduction in late-onset infection.”

sapphiremind

It included other hospitals – my personal hospital showed a complete elimination of NEC that first year. But CLABSI (the line infections) continue to be a problem for all hospitals, specifically the hospital that published the study, and while you don’t want to acknowledge the truth, it was a dramatic improvement in all outcomes. Most hospitals mortality rates for NEC are thankfully pretty low already.

Developing NEC is multifactorial and you can develop it without having been fed at all. But having a huge reduction like that is a very important thing to many parents whose children would have otherwise needed surgery and may have ended up with short gut.

Roadstergal

Oh, so your comment “all breastmilk has those preventative properties” is ‘all breastmilk at one particular hospital in one particular timeframe that I know of’? You need to be more specific.

Nobody here denies that optimal breastmilk reduces the risk of NEC in preemies. What we are stating that you are disagreeing with is:
-Not every women’s breast milk is optimal
-The NEC risk is reduced, not eliminated
-The benefit is for preemies – in term infants, the differences between breastmilk and formula is negligible, and other factors overwhelm those differences. As you can seen on the population level.
-Lying to women about the benefits of breastmilk is a Bad Thing

My question, again. As we’re getting better and better at preventing NEC, we are heading to the point where formula will be more reliable than breastmilk. At that point, breastfeeding even for preemies will be something that women will do if they want to and can, and won’t feel forced to if they don’t and/or can’t. Will you consider this to be a bad thing? I ask because you seem to consider it to be a bad thing for mothers of term infants now.

sapphiremind

I would not consider it a bad thing no, not if it is truly equivalent.

Roadstergal

Once we have a better grip on the protective factors, preemie formula will probably be better, not equivalent, since not all breastmilk is created equal (literally).

So why do you consider it a bad thing for term infants now? Why do you feel that lying to women is appropriate, to keep them making what you consider to be the ‘right’ choice when it comes to feeding their babies?

guest

If I didn’t buy many of those breastfeeding items, I would not have been able to breastfeed. I don’t see how you can say that’s not a “need.”

No pump while babies are in NICU = no milk when they get out. Need, plain and simple.

sapphiremind

If your baby is in the NICU, many/most of those things can be provided for you, if needed. But this was also just referring to a more “normal” situation of breastfeeding.

Elizabeth A

I wound up acquiring most of those things for my first baby (full-term) because I was going to school, and because I had a job. If we’re going to be honest about the cost of breastfeeding, we need to count the cost of associated stuff involved in breast feeding, and the cost of the mother’s foregone income.

guest

Anything “could” be provided – formula was provided, but not a breast pump.

momofone

There’s a regular here who computed the cost of breastfeeding to her, in the range of $130/wk due to missed time at work. That doesn’t begin to count the pump and other supplies she used.

I breastfed for 21 months, and pumped for 10 of those. I was fortunate to have a flexible work situation for pumping, but time is not free. It’s great that for you it didn’t require much in the way of expense (if I’m understanding you correctly), but to assume that it works that way for everyone is a mistake.

The Bofa on the Sofa

There’s a regular here who computed the cost of breastfeeding to her, in the range of $130/wk due to missed time at work. That doesn’t begin to count the pump and other supplies she used.

With our first, my wife couldn’t pump enough to keep him sustained while she was at work. Based on pumped milk alone, she might have been able to have enough for her to work through maybe 7 mos. As it was, I cut her milk with formula, and he ate just fine. With that, she was able to work until he quit nursing, which was 9 months.

She was only working 2 days a week. However, she makes a lot, so even two months at 2 days a week is about $5000. That’s what we couldn’t have had if she were exclusively breastfeeding.

Without our second, he wouldn’t even touch EBM from a bottle, so it didn’t matter how much she pumped. She would have had to not work. He started daycare at 4 months, and quit nursing at 10 months. It was more than $15000 she made over that stretch that we would not have had if she were breastfeeding.

Roadstergal

“Well, all breastmilk has those preventative properties”

No. Not every mother’s breastmilk prevents NEC. The search for the active components is ongoing and quite interesting. This paper comes to mind – I saw this dude talk at DDW, and he’s a frikkin’ lactivist to top you, but he can’t get around the data showing, well:http://www.ncbi.nlm.nih.gov/pubmed/24919691
“Most intriguingly, the data also indicated that low concentrations of DSLNT in the 4-d milk samples in the mother’s milk increased the infant’s risk of NEC (200 ± 126 vs. 345 ± 186 μg/mL; P < 0.05), which is in accordance with results from previously published animal studies and warrants further investigation"

And here's a meta-analysis. It found 'borderline statistical significance' for the risk reduction with donor milk vs formula (read: breast milk only slightly reduced, rather than eliminated, the incidence of NEC), and adds the caveats:
"Moreover, in the included trials, parents or carers were not blind to the intervention, and the possibility that these are biased outcomes remains. " and "These changes, including the use of antenatal steroids and exogenous surfactant, may have altered the potential impact of feeding with donor human milk on the risk of NEC. It may be that the findings of this review are not wholly applicable to the modern population of preterm and low birthweight infants."

As formula gets better, the difference between breastmilk and formula gets smaller, even for preemies. I look forward to the day – and I can see it coming in my lifetime – when women aren't forced to pump for their preemies, but can do it if they wish or use their limited energy in this challenging situation in other ways if that works out better for them.

And if you're not a horrible person, so will you.

Charybdis

Thank you for posting this. I was trying to find the article/s that show that not all breastmilk is preventative for NEC.

Sarah

Whether a formula company makes more profit isn’t relevant to the question of whether an individual member of the breastfeeding industry is reliant on breastfeeding promotion for their income and therefore biased, though.

As for discouraging pumping, Amy makes it clear in this post she’s talking about term infants. The people muddying the message that it’s beneficial to premies, not so much for term babies aren’t those who spell it out.

guest

What’s your evidence that when mothers think formula and breast milk is equivalent that mothers of fragile NICU babies then reject medical advice from doctors who say take 2-3 sentences to explain that preemies are at risk of NEC and providing breastmilk reduces this risk? Because I don’t believe that’s actually a problem. That’s like saying because we all know room air is perfectly good for babies, mothers of preemies are “difficult to convince” of the need for CPAP and incubators.

sapphiremind

You’d be amazed. I’ve seen it first hand. And a lot of times parents don’t want CPAP because “the baby looks uncomfortable” yep. They are. Or they don’t want pain meds. Or they don’t want pressors. (because they don’t want their child to be getting sicker) or they don’t want them intubated even when they are gasping for air, because they know it might lead to a trach this time. People do a lot of crazy things.

guest

No, I want evidence, not anecdote. Prove to me that lying to parents saves lives in the NICU.

guest

Yep. We’re basically all in agreement that pre-term infants have a clear benefit from breast milk. But mothers of pre-term infants can have higher rates of difficulty providing breastmilk. Screened milk banks should serve this population first. But note that some pre-term infants also need a special calorie-rich formula to help them gain wait. The decisions must be made on a case-by-case basis, not by sweeping bans of formula.

Bombshellrisa

Tell her civilized people don’t talk about other people’s breasts and how they choose to use (or not use) them. Or do what I have done lately and just be silent.

I think bottle feeding would have been rather safer for this poor mite.

Roadstergal

I can’t add to the excellent advice given below – do what works for you, both for feeding your baby-to-be (congratulations!) and for the strategy to keep her out of your beeswax.

I will just mention that there’s some interventional research suggesting that early (4-6 months) introduction of common food allergens (dairy, egg, peanut) reduces the risk of food allergy, and that research is less plagued by confounders than the benefits of breastmilk. Just something to keep in mind, when folk talk about the advantages of extended EBF.

Wombat

I’d totally go the ‘Oh, we don’t want it’ or ‘We’re worried it doesn’t even have a mouth, ultrasound next month to find out’ approach, but I have pretty dry dark humor. Then once it becomes clear that’s not the case later perhaps she’ll have taken the hint or at least moved on to another target.

You’d hope the fact that you would need to invoke such a thing to get her to eff off would chide her, but prob not unfortunately.

I think your only real(er) option is what people recommend below: constant refusal to engage. “Not interested, sorry”. Depending on how close she is in the family (meaning how often you’re likely to see her/how likely you are to cause a riff by being any degree of rude) you may have to tailor the phrase some, but still. Don’t tailor it to include any kind of “Not now, talk to me when ___ (baby is born, we’re weaning, etc)” though. Probably goes without saying, but jic it seems like an easier way out.

Amy

I breastfed both my kids past age three, so I can answer about the “benefits:” it worked for US. I didn’t mind (and when I did start minding, I quit nursing them), they liked it, that was it.

Here’s how you answer your lactivist cousin. You don’t bother arguing with her about breastfeeding itself; you call her out on her rudeness. Use the broken-record approach. When she brings up breastfeeding, tell her your parenting decisions are not open to discussion. Like, I would use the phrase, “I’m not going to discuss this with you, sorry.” Eventually she’ll get it, or everyone else present will realize how rude she’s being if she doesn’t.

demodocus

What they said.
A cousin of mine was recommending I stop my zoloft (because any medication during pregnancy is bad or something) and was recommending “talking to my minister or going holistic”. I politely told her that I’d already tried other things and that being suicidal didn’t help the baby or the rest of my family either, then changed the subject. Then I groused about it here.

BF, FF, or combo, do what works for you. My 1st was bf with a tiny bit of formula, my 2nd is ff with a tiny bit of breastmilk, because I grew to loathe bfing. Thinking about it was actually making my depression worse.

Cartman36

Please, for your own sanity now and for the next nine months, just have a very direct conversation with this family member. I would say to her “I appreciate your enthusiasm for breastfeeding, and if I have questions I will be sure to ask, but I need to how I will or won’t feed this baby to be an off limits subject moving forward.” If she continues say “I’m not going to debate you.” If family members try to intervene because of hurt feelings just say “I’m not being unreasonable by refusing to discuss my private health information”.

It’s going to be a hard conversation but it’s better than suffering in silence for the next few years. Just be gentle but firm and direct and stand your ground.

Good luck!!! The regulars here are very supportive of choice in infant feeding so it’s a good place to ask questions.

CSN0116

You
Section
Research
Midwives

I don’t dare touch the punctuation.

But I’m sure you’re well read, as you state 😉

Amy

I think resurge is one of my favorite mistakes ever in a comment section!

Wombat

I want to know what the unrenderable (for me at least) special character was! Even in regurgitating – sorry, resurgitating – onto your keyboard, how do you pull that off?

Oh yeah, it (per google anyways) is. I figured to try copy/pasting + searching it after I posted and figured it out, but didn’t bother to report back.

Guess he was on mobile. Still a little surprised he could hit the emoji button given the example of typing provided, but hey, good for him I guess 😛

Charybdis

I would tell her something like: “Thanks for the information. I’m not sure what I’m going to do yet. If I have any questions, I’LL ask YOU, but for now, the subject is closed. I don’t wish to discuss it with you”. Then, if she brings it up, remind her that you don’t wish to discuss it and change the subject or excuse yourself. Or ask her to leave. Or you leave. Don’t try to explain your thinking, she doesn’t want to know. She just wants you to breastfeed at all costs.

I might be tempted to tell her that you will not be breastfeeding, purely out of spite because she will not BUTT THE HELL OUT. If she successfully breastfed her kids until kindergarten, good for her. It worked for HER. You are not her, so you will do your own thing.

MI Dawn

Actually, yes. We know the research. And we know that C-sections aren’t bad, and formula feeding isn’t bad. We know that vaginal births have risks to mother and baby, and not all women can or WANT to breast feed. That’s the point.

Marki17

MI Dawn True that could happend hope u also know that C section also have risk to mom and baby the Importen thing is then to choce ur careprovider from how many C section he/she have /year and The reason for them Induktion rate Induction for what reason? I know that its a lots of doctor in the US that do a lots of intervention with out any medical reason Episomies with out any medical reason and that Is not to give the patient informed choises. And nope not all moms want or can breastfeed but do they know that before trying. ….

guest

Doctors in the US do NOT do inductions without medical reasons. You may disagree with their reason, but you can’t walk in at 35 weeks and say “I want an induction” and they’ll say “Okay!” They will not induce unless they have some medical reason for it.

I would not want to be stabbed in the throat, and I see no reason why I should have to try it first to be sure. Same with breastfeeding – no woman should be told she has to try. If she doesn’t want to, she doesn’t want to.

MI Dawn

Marki17: as a former OB nurse and CNM, I know all of that. And I may choose a OB who does lots of C/sections *because* many of his clients are high risk, or I might choose a CNM with a low C/S and transfer rate, if I’m low risk. The issue is I KNOW THE RISKS. There is nothing wrong with any medical intervention. I don’t know about Sweden, but here in the US, in every state I have worked in, OBs avoid episiotomies as much as possible unless medically indicated.

And yes. Many moms DO know they don’t want to breastfeed before delivery. They don’t WANT to try. They may have many reasons – from breast surgery to abuse to “just don’t want to”. And all of those should be respected. NO midwife has the right to say “well, I think you should try”. It is the woman’s body and the woman’s choice.

MI Dawn

Marki17: I’m a CNM. I know the risks and benefits. I know research. YOU don’t know that doctors in the US do a lot of intervention without medical reasoning. You are reaching here.

As for breastfeeding: the words “Nope, I don’t want to” are all a woman has to say as to whether she breastfeeds or not in MY world (granted, that’s not a BFI mindset!). Women have the right to choose whether they ever place a baby to the breast. I’ve said many times, it’s much better to have a happy bottlefeeding mother/baby dyad than an unhappy breastfeeding dyad.

If a woman wants to breastfeed, I’ll support her in every way I can. BUT – if she doesn’t, then I’ll support that choice also. NO, she DOESN’T have to try.

Heidi

Yes, I think you can very well know you don’t want something before trying! Sorry, but this “you have to try, if you don’t try, you want know if you like it” is creepy! It’s no different than trying to coerce someone into doing something sexually they don’t even want to try. There are things I know I will not enjoy sexually before I try them and I’m just not going to try them. I’m also never going to try skydiving either.

Roadstergal

Hey, not everybody likes anal, but how do you know that before trying…

Linden

I’d really advocate disengaging with her on this subject. “Thank you for your comment, Family Member, I’m glad breastfeeding worked out for you. Hey, did you hear about Brexit?” or, “Hey, thanks. I’ve got a lot on my mind at the moment and don’t want to talk about breastfeeding, let’s talk about something else.”
Keep religiously changing the subject. You do not have to explain yourself or your plans. She doesn’t deserve to know.

Sue

Her comment that the benefits “don’t magically disappear from one day to the next” shows she has no idea of how research works.

The Belarus study, which is where a lot of this data comes from, showed that EXCLUSIVE BF for six months or longer only showed benefits UP TO a year of age. The fact is, most of the babies didn’t get sick in that first year at all – whether BF or FF. It;s just a statistical summary of the incidence of infection across the study population.

You can also tell her that, in our wealthy societies, the risks of getting infection are much more related to EXPOSURE – ie other germy kids.

Tori

Nothing to add about what to say to her, as I’d be tempted to say something sarcastic if I chose not to breastfeed, or cry if I wanted to and couldn’t. Neither are probably that useful. But sorry to hear she’s doing this.

Tori

Or ‘every drop counts’. No, not the amount it costs me in supplements and spending time with a pump not my baby, it would have to count an awful lot for it to be worth it. Which is why I come here – I can’t produce the milk, and this reminds me I have no reason at all to feel guilty about this, or for my induction for macrosomia at 38+3 weeks.

Who?

I’m sorry, what a nightmare.

You won’t get a struck match between the benefits of bottle v breast, and nothing is more important than a fed baby. If you must see your cousin, I’d support Beatrice’s suggestion. Alternatively, you could just get a distant look in your eye and/or change the subject when she starts talking about it.

BeatriceC

Some people aren’t worth talking to. Tell her you’re not going to have this conversation with her. Ever. If she brings it up the conversation is over. And then when she does, hang up the phone, leave, escort her to the door, go find somebody else to talk to, whatever you need to to in order to end the conversation. Do it every single time. You don’t need to be rude, but nicely say something like “I told you I wasn’t having this conversation with you, so I am leaving now.” Whatever you say, say it without changing a single word every single time, and say it with a smile. Give her one single warning and then from that point on, end the conversation without warning.

Linden

You beat me to it. People like that need some boundaries, rigorously enforced.

MI Dawn

Awesome advice!

Amy

Perfect comment.

I’ll add one thing. If she brings it up on social media, delete her posts and comments. If it’s on Facebook, YOU can control what’s on your page. (You can’t control what’s on hers, but if she tags you in a post, you do have the option to un-tag yourself.) If she tweets at you, block her or just ignore her.

Seattle Mom

We could argue breastfeeding is like homeopathy. Only having the absolute smallest amount is best of all!

Jennifer

I keep seeing people make this caveat about breastfeeding offering modest benefits except in the developing world. I actually don’t understand that reasoning. My understanding is this came from incidents in the 70’s when big bad formula marketed to poor ignorant woman who used dirty water with powdered formula and babies got sick. Ok, fine, but why wasn’t the solution fixing the water situation via bottled water, better wells, etc, etc. OR heavily subsidizing or even providing free ready to feed formula? If the water is so terrible, which by the way is not the formula company’s fault, isn’t it bad for mom, who then indirectly puts her baby at risk via breast milk? Also won’t the kid eventually drink the water too, so aren’t you really just delaying the inevitable?

I also have heard the argument that these companies were taking money from impoverished populations and that breast milk is “free” and should be the preferred choice for poor mothers. I call b.s. on that too. It is patronizing to think these women are stupid. They know breast milk isn’t free because most of the women in these countries work in the informal economy and many are the sole or predominate earner in the household. I doubt too many of them have pumps, so breastfeeding means a lot of lost wages and poverty is pretty strongly correlated with poor health. I think they chose to go back to work with the help of formula knowing that the risk from bad water is there, which is a gut wrenching choice, but not entirely irrational especially considering their older children may starve if the family has no income. So instead of developing public health solutions that change the fundamental situation, we harass them with “breast is best.”

guest

It wasn’t just that the water was bad, but that Nestle pushed formula in poor areas by giving free samples at birth – but when the samples ran out, the families couldn’t afford to keep buying formula. But by that point, the mothers’ breast milk had dried up, and so they diluted the baby formula and babies starved. And if you know the water supply isn’t good, it is highly unethical to advertise heavily targeting women in those areas. I don’t know anything about the extent to which this actually happened, just that these are the arguments. And I agree: If that is what happened, Nestle and whoever else have blood on their hands. Did they not realize and stop once they saw what was happening? Or did they know all along? That, I couldn’t say.

But I agree that the solution to this problem is to address why these families don’t have clean water and enough money to buy food.

Sarah

I’ve always thought it was interesting that lactivists, rightly, condemn this behaviour whilst also pretending that anyone can relactate. The terrible side effects of what Nestle did prove otherwise. Their actions wouldn’t have worked if everyone could relactate.

Tori

I’d love to change the ‘breast is best’ to ‘clean water for all is best’. Doesn’t have the same ring to it, but a lot of benefit for a lot more people.

Chant de la Mer

The issue of poor food and water supply is why extended breast feeding is encouraged in those areas. An adult has a better chance of being able to consume the water safely plus the breast milk provides a safe liquid for the infant/toddler. From what I understand most of the waterborne illnesses aren’t transmitted via breastmilk. With poor nutrition, I believe that the child gets food and nurses so they get extra calories from the breast milk. I’m not sure how well it works if the mother is starving but if she is not starving then it helps a nursing child a great deal.

Nick Sanders

Because of things happening like the CEO of Nestle publicly releasing a personal statement saying he doesn’t believe access to drinkable water is a human right, and his company and others working extremely hard to privatize the water supply, even in drought stricken areas.

Jennifer

I am not necessarily defending Nestle. I honestly don’t know enough about their actions. However I do want to push back against the idea formula is only safe/has advantages in the developed world. Formula wasn’t dangerous the water was. I also don’t understand how that story made us think breastfeeding was the ONLY solution. We know it is not “free” which is one justification people have given. Another justification that I think has more merit is that if we give subsidized free formula women will stop producing and then be left high and dry if aid stops. I guess that is a good point but the problem is some babies need formula and many mothers need to go back to work so we need a viable long term solution beyond breast is best. I think this idea formula is harmful in the developing world has really warped our approach to aid. I’ve heard stories of formula donations being turned away from disaster areas though admittedly I don’t know if this happens often or at all.

lawyer jane

I think the role of breastmilk protecting against GI diseases for newborns and infants may also be comparatively more important in poor countries with less access to health care and worse sanitation. But the bigger issue is probably nutrition overall.

SporkParade

Because moralizing women’s body functions is easier and cheaper than providing access to clean water. Also, if you don’t have clean water, you probably can’t can’t store it properly.

denise

I have been thinking about the same issue the other day. First of all, many developing countries are actually fairly well developed, and many have access to clean water. Also, women are not stupid. Even individuals with very little to no formal education, can understand the concept of clean water, and implications of bad formula preparation if explained properly.

Jules B

The hashtag doesn’t even make much sense to me…what do they even mean? That even one or two breastfeeding sessions is better than none?

Amy

That’s exactly what they mean. It’s the line LLL pushes, too.

AA

Looking for @ bombshellrisa–are you here?

Bombshellrisa

Hey! I am here-what’s up?

Who?

Sorry I sent you to the wrong post…glad you found it.

AA

May I ask you some questions about Seattle hospitals ? my junk email is turt1efun@gmail.com (replace the number with the letter L)

guest

#everyfeed counts. There, fixed that. You fed your baby? Hooray! It totally counts no matter how you did it.

Megan

No matter how much I try #everyfeed counts for me too…

demodocus

Every breastfeed counts? so the 6 or 7 such i gave my daughter (because engorgement hurt even worse) will actually make any sort of difference even in the short run? Silly

Heidi

OT: I am struggling with a six month old who wakes up at least 2 to 3 times in the middle of the night to eat. He is taking about a third of his daily formula/breast milk intake during these middle of the night feeds. He takes about 5 oz. at a time, on average at 1am and 3:30am, I’d say. But many nights he squeezes in a third wake-up, and my husband and I’ve about had our share of middle of the night feeds. While I can get him to take 5 oz. or so at night, I’m lucky to get him to take 3 oz. at a time during the day. I feel like he should be at least taking 5 or 6 oz. bottles regularly and at most waking up once in the night but I don’t think sleeping through the night by now is an unreasonable expectation. I’ve read about watering down the bottles to discourage nighttime eating. I was thinking about making 4 oz. of formula and topping it off with an ounce of water tonight. Then moving to half and half and dropping the total amount of liquid while I’m at it – like 2oz of formula and 2 ounce of water, then maybe just offering 2 ounces of plain water if he’s still getting up after a few nights. I know I don’t want to flood him with water obviously. Is this a reasonable idea? I’d really like him to eat more during the day and sleep more at night.

MI Dawn

He may be in the midst of a growth spurt, which makes him hungrier. But it’s also easier to eat more at night from a baby’s point of view- it’s quiet, nothing exciting to look around at, not as much noise, might as well eat.

Heidi

I would chalk it up to a growth spurt if it had just started out of the blue. But it’s like he’s just never dropped any of his nighttime feedings. When he’s had a growth spurt in the past, it was constant feeding during the day. He’s not taking anymore milk than he ever has.

Madtowngirl

My daughter also didn’t really drop any night time feeds until 6ish months. I don’t know how you feel about letting g your baby cry, but our pediatrician did say this would be an appropriate time for letting her cry, because it’s sort of like conditioning – she was eating at night, so her body would send hunger cues at night. Fortunately, she ended up growing out of it before we had to let her cry, because CIO is pretty tough for me. I also think your idea is reasonable, but not being a doctor, I really can’t speak to whether it would be effective or not. But it sounds like it’s worth a try.

Jules B

My girl was like that – she hung onto her nighttime feeds until 10-11 months old, until I was like “forget this!” I did the water thing, but I did it too quickly at first, and she cried endlessly and would not re-settle. She had just gotten in the habit of taking those two big feeds at night. I decided to keep trying the diluting approach, but very very gradually. She dropped her 11-midnight feed fairly well after that, but stubbornly clung to the 2-3am one (ugh!). If I did not feed her a non-watered-down bottle then, she would sometimes just consider that morning and stay awake! It was a nightmare. What I did eventually was keep the 2-3am feed but reduce the amount slowly (versus watering it down), then pop the pacifier in when I took the bottle out (which was hard for me to do, since we had weaned off the paci by then, so this was the only time I ever gave it to her). Finally, she was literally drinking one ounce of formula, then having the paci. Then, a few nights I just had to let her CIO at that time. It was a rough road, but I eventually did it! (I honestly think if I had not done all that, she’s still be waking up at that hour out of habit at four years old!)

MI Dawn

Ah. Then I agree with the others, and do the diluting thing. I did it with my kids, too.

Karen in SC

is he eating solids?

Heidi

Yes.

Megan

If he’s only taking the equivalent of 5 oz at night, you may be able to go cold turkey. This is what we did around 6 months because it had just become a habit for DD to be up eating at night and then she’d take less during the day. It just became a vicious cycle.

Hubby dealt with her for those few nights (which is especially helpful if you’re nursing at night) and we offered water instead. It was rough for about 3 nights and by then she had begun compensating by eating more during the day and it resolved. After that we waited a few weeks and then we were able to start sleep training. I also made sure we offered her a snack before bed. Not sure if this would work for you but it worked for us. DD figured out pretty quick that she wasn’t getting the “good stuff” at night. A more gradual approach like you mentioned would probably work too though may take longer.

Heidi

He’s taking 10oz or more at night. Just 5 oz. at a time.

Megan

Oh sorry. Misunderstood you then. If that’s the case, you will probably have to do it more gradually. I would make sure to give a snack at bedtime with bedtime bottle/nursing and slowly cut back on the volume and/or frequency of feeds at night. Maybe give water every other bottle? I doubt it matters how you decrease the volume but it basically boils down to encouraging more intake during the day while decreasing intake at night. He will probably protest. With my first daughter we did have to make her a little upset at night and deny her formula so she would eat more during the day because I always found that her caloric intake over 24 hours was pretty consistent (minus growth spurts).

Kelly

Maybe drop one of the feeds and over a few days he will compensate. My daughter did the same thing. She is nine months and has started getting a bottle in the middle of the night. We let her cry it out and within a day or two it has resolved itself.
Edited to add that we have also started to give them less in their bottle by about two ounces each time. Once they were only eating one to two ounces at a time, we just dropped it. There was some crying but they would eventually go back to sleep. My kids would cry for about an hour and then within two days they would sleep through that feed. We did both of these depending on the age, child, and duration of the night time feeds. It sounds like you might have to try many things before you find out what works for your child. I tend to be an all or nothing with my kids and these things and it seems to work out well for my kids but it might be different for yours. Good luck. Three times a night at that age is hard.

Heidi

My line of thought was since he was taking such a big chunk of his food at night, gradual might be better, ensuring he doesn’t get too hungy.

J.B.

I’ve definitely heard of people diluting more and more. 6 months ish is probably a good time. My oldest was clearly more interested in play and biting without teeth around then. Fun times.

swbarnes2

Slowly dilutng the night fees is just what the author of preciouslittlesleep recommends. Here are her links on night weaning

Our son started feeding at night around 1 year old, after not eating at night for months. We gradually weaned him during almost one month, decreasing 10 ml (1/3 of an ounce) a night. If the first night he would take 150 ml the next night I would only offer 140 ml (pouring the milk down the sink until only 140 ml were in the bottle), the night after 130 ml, etc. It took about three weeks but it worked with just a little grunting a couple of nights, not crying and it worked very well. I read about the watering, but to me it looked like changing one problem for other, because he might have had wanted water as well, so we did it in the way I have just described.

Who?

We did the same with number 2, in the end she stopped rousing for feeds, I think about 2/3 of the way down the bottle.

Good luck Heidi!

Zornorph

The biggest problem is the hashtag is way too long and uses too many characters given Twitter’s limits. It’s wasteful.

BeatriceC

Semi OT: A woman in one of my Facebook groups posted a picture of part of the baby section at Target. They had the aisle with the breastfeeding supplies labeled as “Natural Feeding”. I feel the need to spam Target with messages of outrage.

Amy M

Well, I feed my children every day, naturally. If I didn’t I’d be a sucky mom. See it all depends on where you put the comma.

Charybdis

So then, what exactly is “unnatural feeding”? Because eating and/or feeding someone/something that cannot eat on its own is pretty natural. I mean, I feed my dog, my son when he was a baby, the neighbor’s cat when they are out of town, etc.

Oh! It just occurred to me! Maybe they mean non-organic, GMO, pesticide and herbicide ridden, hormone laden (never mind that there are hormones in untreated animals) Frankenfood! You think?

BeatriceC

My guess is that they were looking to avoid the word “breast”. I’m not sure why they had to use such a loaded word though. Why couldn’t they use “lactation supplies”, especially since mechanically pumping one’s breast is anything buy “natural”, as are all the other accessories that women today seem to think they absolutely have to have (some of which are awesome and make life easier, some of which are just a way to relieve women of their money).

KeeperOfTheBooks

That was kind of what I was thinking. At a guess, someone, somewhere would have gotten their panties in a twist over Junior, age 7, seeing the word “breast.” Though that does beg the question over whether Mama is equally concerned about Junior walking down the meat aisle and becoming correspondingly…overwrought…at seeing that boneless, skinless chicken boobs are the sale item du jour…

Charybdis

Yeah, they don’t have a problem labeling chicken breasts as such, so why can’t they call breastfeeding supplies “Breastfeeding Supplies”?

Or: “Breast is best, you know, here is our selection of lactation support products, including pumps (milking machines!) because we want you to know that we, Target, know breast is best and that we support your decision to feed your baby in the best, most natural way possible!” Although I think that would be tough to get on an sign….

Roadstergal

Because nothing is more natural than buying a breast pump at Target.

Megan

Yeah that always irked me too. I always make a snarky comment about it when I’m there. I guess target can’t say “breast.” /eyeroll

Madtowngirl

Ugh, I noticed that, too. Drives me crazy, especially since they have “OMG NACEURAL ORGANIC baby food” in a different aisle.

Wombat

It’s “Nursing & Feeding” on at least one section of their website.

I’d loveeee to see the outrage over the ‘othering of breastfeeding as not feeding’ there.

P.s. I can now officially not think the word ‘hashtag’ without hearing it in John Oliver’s perfect sarcastic delivery.

Box of Salt

Hashtag.

My kids have no idea that it started as the number sign.

My maternal grandmother lived through most of the 20th century, and I though that there’s no way the world could be transformed as much within a single person’s lifetime as it had through hers. I am now doubting that.

Amy M

If every breastfeed counts, why is just one bottle of formula harmful?

Charybdis

Because you cannot dilute out the *evil* in formula with a tsunami of breastmilk. If you are going to “poison” your child with that “shit in a can”, no amount of breastmilk will EVER make up for that. Better to stick to breastmilk only, no matter how much it hurts, is inconvenient, is inadequate or insufficient.

(please say I don’t need to mention that this is snark)

Azuran

It’s because of the homeopathy principle!!!
Once 1 drop of formula crosses your baby’s lips, the more you dilute it with breastmilk, the more potent and dangerous it becomes.

Charybdis

Ahhh, yes! I see! That MUST be the explanation!

Roadstergal

Ah, homeopathy – so a little colostrum and then EFF is maximal breastmilk potential.

Mrs.Katt the Cat

But then adding a few drops of breastmilk and shaking it really hard would make formula a homeopathic breastmilk feeding- problem solved!
I am now going to claim that I give my baby homeopathic breastmilk. Maybe I’ll reiki the bottles too, hit them with the Om fork to make it resonate with the earth, and have a super awesome natural energetic baby!

Roadstergal

Just one bottle? You insane risk-taker! It’s just one _drop_!

The Bofa on the Sofa

I have mentioned in the past that my younger guy wouldn’t drink from a bottle if there is just one drop of breast milk in it. He would only take formula, and if we tried to blend in any breastmilk at all, he wouldn’t touch it.

Zornorph

Because you will bust your LO’s virgin gut cherry.

Mrs.Katt the Cat

That comment is horrible, and beautiful, and made me laugh!

LaMont

Because one bottle of formula takes away one breastfeed, and each breastfeed is super amazingly helpful! Each one you take away is a huge step back!!

Azuran

Each time you feed your baby a bottle, it completely wipe away it’s brain and reverts it back to how it was when it was born and removes an additional 5%.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
More